Prevalence of intestinal parasites, salmonella and shigella among apparently health food handlers of Addis Ababa University student's cafeteria, Addis Ababa, Ethiopia

Prevalence of Salmonella spp., Shigella spp., and intestinal parasites among food handlers working in University of Gondar student's cafeteria, Northwest Ethiopia

Background

Food-borne infections continue to be a major public health problem at the international level. The issue becomes more serious in developing countries like Ethiopia.

Objective

This study aimed to examine the prevalence of Salmonella and Shigella species and intestinal parasites, as well as antimicrobial resistance patterns and associated factors among food handlers at the University of Gondar cafeteria in northwest Ethiopia.

Methods

An institutional-based cross-sectional study was conducted from February to June 2021 in the University of Gondar cafeterias. Data related to the socio-demographic characteristics and hygienic practices of study participants were collected using structured questionnaires. A total of 290 stool samples were collected from food handlers. Culture and conventional biochemical tests were used to isolate the Salmonella and the Shigella species. Wet mount, Formol-ether concentration, and Kato Katz techniques were applied to identify intestinal parasites. Additionally, drug susceptibility tests were performed using the disk diffusion method. Statistical analysis was done using SPSS version 26.

Results

Of 290 food handlers' stool samples analyzed, Twenty-seven 27 (9.3%) were positive for both Salmonella and Shigella species. The prevalence of Salmonella and Shigella species was 16 (5.5%) and 11 (3.8%), respectively. Most of the isolated pathogens were resistant to tetracycline 19 (70.4%), and trimethoprim/sulphamethoxazole 19 (70.4%). The overall rate of multi-drug resistant Shigella and Salmonella isolate was 59.3%. Besides, Fifty-seven 57 (19.7%) of the participants were positive for one or more intestinal parasites. The most prevalent intestinal Parasitosis was E. histolytica/dispar 22 (7.6%), followed by G. lamblia 13 (4.5%), and Ascaris lumbricoides 11 (3.8) not washing hands after using the toilet (AOR: 4.42, 95% CI: 1.57, 10.56), and consuming unpasteurized milk (AOR: 3.14, 95% CI: 1.65, 3.96), were factors significantly associated with the prevalence of Salmonella, and Shigella infection. Similarly, not washing hands after using the toilet (AOR: 2.19, 95% CI: 1.0, 1.4), and consuming unpasteurized milk (AOR: 10.4, 95% CI: 3.8, 28.8), were factors significantly associated with the prevalence of intestinal parasites infection.

Conclusion

The prevalence of intestinal parasites, Salmonella, and Shigella species was high. Therefore, it is imperative to implement a public health policy that includes ongoing microbiological surveillance.

Relationship between Desiccation Tolerance and Biofilm Formation in Shiga Toxin-Producing Escherichia coli

Shiga toxin-producing Escherichia coli (STEC) is a major concern in the food industry and requires effective control measures to prevent foodborne illnesses. Previous studies have demonstrated increased difficulty in the control of biofilm-forming STEC. Desiccation, achieved through osmotic stress and water removal, has emerged as a potential antimicrobial hurdle. This study focused on 254 genetically diverse E. coli strains collected from cattle, carcass hides, hide-off carcasses, and processing equipment. Of these, 141 (55.51%) were STEC and 113 (44.48%) were generic E. coli. The biofilm-forming capabilities of these isolates were assessed, and their desiccation tolerance was investigated to understand the relationships between growth temperature, relative humidity (RH), and bacterial survival. Only 28% of the STEC isolates had the ability to form biofilms, compared to 60% of the generic E. coli. Stainless steel surfaces were exposed to different combinations of temperature (0 °C or 35 °C) and relative humidity (75% or 100%), and the bacterial attachment and survival rates were measured over 72 h and compared to controls. The results revealed that all the strains exposed to 75% relative humidity (RH) at any temperature had reduced growth (p < 0.001). In contrast, 35 °C and 100% RH supported bacterial proliferation, except for isolates forming the strongest biofilms. The ability of E. coli to form a biofilm did not impact growth reduction at 75% RH. Therefore, desiccation treatment at 75% RH at temperatures of 0 °C or 35 °C holds promise as a novel antimicrobial hurdle for the removal of biofilm-forming E. coli from challenging-to-clean surfaces and equipment within food processing facilities.

Enteric Bacterial Infections, Antimicrobial Susceptibility Pattern, Intestinal Parasites, and Associated Factors Among Food Handlers in Yabelo Town, Borena Zone, Southern Ethiopia

Background

Foodborne illnesses are the main cause of morbidity and mortality in the twenty-first century, and food handlers are the main source of these illnesses.

Objective

The study aimed to assess the prevalence of intestinal parasites, enteric bacteria, antimicrobial susceptibility patterns, and associated factors among food handlers working in a food and drinking establishment in Yabelo town, Borena zone, Southern Ethiopia, in 2022.

Methods

A facility-based cross-sectional study design was employed to assess the food handler's state of health. Data were gathered using semistructured questionnaires and observational checklists, and 396 regular stool samples were collected. Samples were examined with microscopy and bacteriological culture to isolate enteric bacteria. Statistical Package for the Social Sciences, version 26 The factors that had a P-value of <.05 were considered statistically significant.

Result

Of the 396 stool samples collected, 164 (41.4%) were tested positive for intestinal parasites, while 40 (10.1%) were positive for enteric bacteria (Salmonella and Shigella). Among intestinal parasites, the most predominant parasite was Ascaris lumbricoides 48 (12.1%). All isolates of Salmonella and Shigella showed resistance to ampicillin. In multivariable analysis, not trimming fingernails regularly (AOR = 2.02, 95% CI 1.97-5.37), not washing hands with soap after the toilet (AOR = 3.02, 95% CI 2.37-5.62), and eating raw food (AOR = 2.1, 95% CI 1.79-6.51) have a significant association with the prevalence of bacteria and parasites.

Conclusion

The majority of food handlers had poor hygiene practices, and the prevalence of parasites and bacteria was high in the study setting. Educational status, eating raw vegetables or fruit, hand washing after the toilet, and fingernail trimming have associations with the health status of food handlers.

A Systematic review on Prevalence, Serotypes and Antibiotic resistance of Salmonella in Ethiopia, 2010-2022

Background

In Ethiopia, salmonellosis is one of the most common zoonotic and foodborne illnesses. Ethiopia continues to be at risk for its fast-expanding medication resistance. For the development of preventative and control methods, summarized knowledge regarding salmonellosis is necessary. Determining a thorough evaluation of the prevalence, serotypes, and antibiotic resistance of Salmonella in humans and animals from January 1, 2010, to December 30, 2022, in Ethiopia was our goal.

Methods

To find Salmonella related articles that published in English, we used the Google Scholar and PubMed search engines. Three researchers conducted the eligible studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, making sure to include the necessary keywords. If studies were duplicates, incomplete publications, or reported without an antimicrobial test were excluded. Excel 2013 was used to calculate frequencies and tabulate data.

Results

There were a total of 43 investigations from food handlers, diarrhoeic patients, and animals. The prevalence rates ranged from 1% to 10% and 1% to 13% among food handlers and diarrhoea patients, respectively. The highest prevalence was among pigs (41.6%). S. Anatum in animals and S. Typhimurium in people were the predominant serotypes. Amoxicillin and ampicillin were claimed to be 100% resistant in human studies. The highest recorded resistances for ceftriaxone and ciprofloxacin were 16.7% and 100%, respectively. Animal studies revealed that Salmonella resistances to ampicillin, streptomycin and tetracycline were 100%, 90%, 86.4%, respectively. S. Kentucky showed complete resistance to tetracycline, ampicillin, gentamicin, ciprofloxacin, and streptomycin.

Conclusion

The prevalence of Salmonella among asymptomatic food handlers, diarrheal patients and animals were high in Ethiopia. S. Typhimurium that have the zoonotic importance was presented predominantly in human study. High levels of resistances were showed to tetracycline, ampicillin and streptomycin in animal studies. Salmonellosis prevention and control techniques should be strengthened.

Occurrence of Diarrheagenic Pathogens and Their Coinfection Profiles in Diarrheic Under Five Children and Tracked Human Contacts in Urban and Rural Settings of Eastern Ethiopia

Diarrheagenic Escherichia coli, Campylobacter, Nontyphoidal Salmonella, and Shigella are common cause of childhood diarrhea in countries like Ethiopia, but data on their sources and coinfection profiles is limited. A cross sectional study was conducted from November 2021 to January 2023 to determine the prevalence, coinfection, and monthly occurrence rates of major diarrheagenic bacteria in diarrheic under five children and asymptomatic contacts at urban and rural settings in Ethiopia. A total of 345 stool samples were collected from; 262 diarrheic children visiting Hiwot Fana Hospital, Kersa, and Adelle Health Centers; and 83 caretakers and siblings through case based contact tracing. Samples were analyzed using standard laboratory procedures and the overall prevalence of enteric pathogens was 26.96%, with the highest isolation rate during the winter and peaks of 73.91% in February. The occurrence of the pathogens in children and tracked contacts was 27.86 and 24.09%, respectively. In our study, 8.53% coinfection and 23.66% single pathogen infection was recorded in diarrheic children. The study also showed 4.51 and 3.88% of diarrhea in children from urban and rural had attributed to bacterial coinfection, respectively. The most prevalent pathogen in diarrheic children was Diarrheagenic E. coli (10.31%), and followed by Campylobacter. On the other hand, Diarrheagenic E. coli was the second dominant bacteria following Shigella in the traced contacts, with prevalence of 8.43% and 9.64%, respectively. Based on the study site, the prevalence of Diarrheagenic E. coli and Nontyphoidal Salmonella was higher in children from urban than those from rural. However, the occurrence of each pathogen had no significant differences (P > .05) between settings. The high pathogens occurrence rate in the current study indicates the need for strong control strategies and better child carrying and treatment of diarrheal diseases at both urban and rural settings. Further studies on possible sources and factors attributing to the occurrence of enteric pathogens in children are also recommended.

Antimicrobial Susceptibility Patterns of Shigella Species among Children under Five Years of Age with Diarrhea in Selected Health Centers, Addis Ababa, Ethiopia

Background

Shigella and parasitic infections are common public health problems throughout the world. Shigellosis is an acute gastroenteritis infection and one of Ethiopia's most common causes of morbidity and mortality, especially in children under five. High resistance rates to commonly used antibiotic agents have been documented in different locations in Ethiopia.

Objective

This study aimed to characterize the antimicrobial features of the Shigella species isolated from children under five years of age with acute diarrhea in Addis Ababa, Ethiopia.

Methods

Using a cross-sectional study, freshly passed fecal specimens were collected for intestinal parasite and bacterial isolation. Fecal samples for bacterial identification were placed immediately in Cary-Blair media and transported to the Ethiopian Public Health Institution (EPHI) laboratory. Antimicrobial susceptibility testing (AMST) was conducted using the disk diffusion method. Data were described using descriptive statistical tools. The association of independent and dependent variables was evaluated with logistic regression. A P value ≤0.05 was considered statistically significant.

Results

The prevalence of intestinal parasites was 8.2% with seven different species. Among the 534 stool-cultured specimens, 47 (8.8%) were positive for Shigella species. Antimicrobial susceptibility testing (AMST) showed that 100%, 93.6%, 80.9%, 72.3%, and 57.5% were susceptible to norfloxacin, nalidixic acid, ciprofloxacin, gentamicin, and cefoxitin, respectively. However, 100% of the isolates were resistant to amoxicillin and erythromycin. More than 50% of the isolates were resistant to three and above antibiotics, while none of them were susceptible to all the antibiotics tested. All risk factors assessed did not show a statistically significant association with Shigella infection.

Conclusion

The high levels of antibiotic resistance observed among the commonly prescribed antibiotics are alarming. The emerging resistance to ciprofloxacin and nalidixic acid signals a severe public health threat in the management of shigellosis. Raising awareness about resistance and educating health professionals, policymakers, and the public can help improve the quality of patient care and rational antibiotic use.

Food Hygiene and Fecal Contamination on the Household Compound are Associated with Increased Pediatric Diarrhea in Urban Bangladesh (CHoBI7 Program)

In this prospective cohort study, we explored individual- and household-level risk factors associated with diarrheal diseases among 251 children younger than 5 years in slum areas of urban Dhaka, Bangladesh. During the 3-month study period, diarrhea surveillance was conducted monthly, and spot checks of the household compound were performed at baseline to assess the presence of feces (animal or human) in the household compound and in cooking and food storage areas, and to assess whether cooked food was covered and refrigerated. We also collected caregiver reports on child mouthing behaviors. Children living in households with feces within 10 steps of cooking and food storage areas (odds ratio [OR], 8.43; 95% CI, 1.01-70.18), those with visible feces found on the ground of the household compound (OR, 4.05; 95% CI, 1.24-13.22), and those in households found to keep cooked food uncovered and without refrigeration (OR, 6.16; 95% CI, 1.11-34.25) during spot checks had a significantly greater odds of diarrhea. There was no significant association between pediatric diarrhea and caregiver-reported child mouthing behaviors or presence of animals in the cooking area. These study findings demonstrate that presence of visible feces in the household compound and near cooking and food storage areas, and poor household food hygiene practices, were significant risk factors for diarrheal disease among young children in Dhaka, Bangladesh. Health communication programs are needed to target these exposure pathways to fecal pathogens.

Prevalence of Blastocystis sp. among cooks in the region of Fez-Meknes (Morocco)

Cooks have an important role in the dissemination and transmission of enteropathogenic microorganisms, including intestinal parasites such as Blastocystis sp. responsible for blastocystosis. Blastocystis is a unicellular, anaerobic, eukaryotic protist that colonizes the intestinal tract of many hosts. It is the most common parasite found in human stool. It can be the cause of acute digestive disorders which could lead to chronic syndromes such as irritable bowel syndrome. The aim of the present study is to determine the prevalence of this protozoan in cooks in the Fez-Meknes region. This is a retrospective descriptive analytical study carried out in the Parasitology-Mycology laboratory of the Moulay Ismail Military Hospital in Meknes. Out of a total of 200 parasitological examinations of cooks' stools, 88 (44 %) cases were positive for intestinal parasites. Blastocystis sp. is the most frequently encountered protozoan in our study. It represents 39.78 % of those infected. It is associated in 48.57 % of cases with another intestinal parasite. Dientamoeba fragilis (D. fragilis) is the most found in 31.43 % of co-infections, respectively followed by Entamoeba coli (E. coli) (8.57 %), Endolimax nana (E. nana) (5.71 %) and Pseudolimax boutschlii (P. boutschlii) (2.86 %). Our results showed a high prevalence of Blastocystis sp. in the kitchen staff population. These workers must be considered as reservoirs of this microorganism, and therefore a source of infection in those around them. Consequently, preventive measures are necessary, including raising awareness among this population in order to effectively fight against the infestation by this protozoan in particular and other parasites in general.

Foodborne disease hazards and burden in Ethiopia: A systematic literature review, 1990–2019

Background

Foodborne disease (FBD) affects millions of people each year, posing a health burden similar to malaria, tuberculosis or HIV. A recent World Bank study estimated the productivity losses alone attributed to unsafe food within Africa at $20 billion in 2016, and the cost of treating these illnesses at an additional $3.5 billion. Ethiopia faces multiple food safety challenges due to lack of infrastructure and basic pre-requisites for food safety such as clean water and environment, washing facilities, compounded by limited implementation of food safety regulations, and a lack of incentives for producers to improve food safety. A consolidation of our understanding and evidence of the source, nature and scale of FBD in Ethiopia is needed to inform policy and future research. We performed a Systematic Literature Review (SLR) of publications on FBD occurrence in Ethiopia including hazard presence and impact.

Method

The SLR followed Cochrane and PRISMA guidelines. We searched PubMed and CAB-Direct for relevant publications between 1990 and 2019 (inclusive). Observational studies and reviews were included. Two reviewers screened titles and abstracts, and retained publications were reviewed in full for quality and data extraction.

Result

In total 128 articles met the inclusion criteria. Most articles focused on the identification of biological hazards in food. High levels of microbial contamination in different food value chains were often found in the small, ad hoc, observational studies that dominated the literature. Raw milk (22/128, 17.0%) and raw beef (21/128, 16.4%) were the most studied food products. Foodborne (FB) parasites were often found at higher rates in food than bacterial and viral pathogens, possibly due to differences in ease of identification. High levels of bacterial contamination on the hands of food handlers were widely reported. There were no reports on the incidence of human FBDs or resulting health and economic impacts.

Conclusion

Our findings reflect existing concerns around food safety in Ethiopia. A lack of substantial, coordinated studies with robust methodologies means fundamental gaps remain in our knowledge of FBD in Ethiopia, particularly regarding FBD burden and impact. Greater investment in food safety is needed, with enhanced and coordinated research and interventions.

Intestinal Parasitic Infections and Associated Risk Factors among Food Handlers of Food and Drinking Establishments in Woldia Town, North-East Ethiopia: A Cross-Sectional Study

Background

Food handlers should be screened periodically for intestinal parasitic infections, and they should be treated to reduce intestinal parasite transmission to consumers through contaminated foods and drinks. Therefore, this study aimed to assess the prevalence and associated risk factors of intestinal parasitic infection among food handlers in Woldia town, North-East Ethiopia.

Method

A community-basedcross-sectional study was conducted among food handlers in Woldia town, North-East Ethiopia. A structured questionnaire was used to collect sociodemographic characteristics and intestinal parasite-associated risk factors. Microscopic examination of a stool sample was performed using wet-mount and formol-ether concentration techniques. Data were analyzed using SPSS version 20.0 statistical software packages. Bivariate and multivariate analyses were performed to investigate the association between intestinal parasitic infections and associated risk factors. In all comparisons, P value <0.05 was considered as statistically significant.

Result

The overall prevalence of intestinal parasitic infection among food handlers in Woldia town was 14.3%. Six different intestinal parasites were detected. The majority of the parasites identified were helminthic infections 37/52 (71%). Ascaris lumbricoides was the most dominant parasite (7.7%), followed by E. histolytica/dispar (2.7%) and G. lamblia (1.4%). Multivariate logistic regression analysis showed that intestinal parasitic infection had a statistically significant association with food handlers' habits of hand washing without soap after latrine use (P < 0.01), swimming habit (P=0.03), and using a common knife (P < 0.01).

Conclusion

This study revealed a relatively high prevalence of intestinal parasites among food handlers in Woldia town. Strict and standard hygienic and sanitary practices should be implemented by food handlers. Moreover, food handlers should be screened for intestinal parasitic infection, and health education should be given periodically.

Intestinal Parasitosis and Associated Factors Among Food Handlers Working in the University of Southern Ethiopia

BACKGROUND

Intestinal parasite infections are major global public health problems. The majority of persons infected reside in Sub-Saharan Africa with a high burden of the disease. Very few studies have been done in Ethiopia and none exist at Wachemo University, Southern Ethiopia. The present study aimed to investigate intestinal parasitic infections and associated factors among Wachemo University students' cafeteria food handlers.

METHODS

Institution-based cross-sectional study was conducted on 212 randomly selected food handlers from 15, February to 05, March/2019. A structured questionnaire was used to collect data and standard laboratory procedures were employed to collect stool and finger specimens and analyzed them for intestinal parasites. Data were edited, cleaned, entered, using EPI data 3.3.1, and analyzed by statistical package for social science version 20. A stepwise logistic regression model was used to calculate the odds ratios and 95% confidence interval for the different factors.

RESULTS

Of 212, the majority 63.7% were females and 48.1% attended grades 9 to 10. Of the stool and fingernail specimens examined, 29.7 % and 5.6% were positive for different parasites, respectively. The most prevalent parasite is Ascaris lumbricoides (12.7%) followed by Hookworm (6.6%), Giardia lamblia (4.7%), Taenia saginata (2.4%), and mixed infection (3.3%). Although several factors showed significant association with intestinal parasitosis, attending secondary level education 94.5% (AOR: 0.055; 95% CI [0.007-0.413]), fingernail status (AOR: 0.330; 95% CI [0.113-0.965]), and hand washing with soap and water after toilet use (AOR: 0.332; 95% CI [0.125-0.884]) were the significant variables in multivariable analysis (P < .05).

CONCLUSIONS

The results demonstrated intestinal parasite infections as a public health issue in Ethiopia that requires attention. Appropriate intervention programs like encouraging food handlers to practice good hygiene, routine hand washing at key times, and nail trimming should be implemented.

Prevalence and Associated Risk Factors of Intestinal Parasites and Enteric Bacterial Infections among Selected Region Food Handlers of Ethiopia during 2014-2022: A Systematic Review and Meta-Analysis

Food-borne disease due to intestinal parasites (IPs) and enteric bacterial infections (EBIs) remain a major public health problem. Food handlers, individuals involved in preparing and serving food, working with poor personal hygiene could pose a potential threat of spreading IPs and EBIs to the public. The aim of this study was to examine the overall prevalence and risk factors of IPs and EBIs among food handlers in four selected regions of Ethiopia. Scientific articles written in English were recovered from PubMed, ScienceDirect, Web of Science, Google Scholar, Cochrane Library, and other sources from Google Engine and University Library Databases. “Prevalence,” “Intestinal Parasites,” “Enteric Bacterial Infections,” “Associated Factors,” “Food Handlers,” and “Ethiopia” were the search terms used for this study. For critical appraisal, PRISMA 2009 was applied. Stata software version 16 was used to perform the meta-analysis. Heterogeneity and publication bias were evaluated using Cochran's Q, inverse variance (I²), and funnel plot asymmetry tests. A random-effects model was used to calculate the pooled burden of IPs and EBIs and its associated factors among food handlers, along with the parallel odds ratio (OR) and 95% confidence interval (CI). For this meta-analysis, a total of 5844 food handlers were included in the 20 eligible studies. The overall pooled prevalence of IPs and EBIs among food handlers in four selected regions of Ethiopia was 29.16% (95% CI: 22.61, 35.71), with covering (25.77%) and (3.39%) by IPs and EBIs, respectively. Ascaris lumbricoides, Entamoeba histolytica/dispar, Giardia lamblia, and hookworm were the most prevalent IPs among food handlers with a pooled prevalence of 7.58%, 6.78%, 3.67%, and 2.70%, respectively. Salmonella and Shigella spp. were the most prevalent EBIs among food handlers with a pooled prevalence of 2.78% and 0.61%, respectively. A high prevalence of IPs and EBIs among food handlers was observed in Oromia (38.56%; 95% CI: 29.98, 47.14), while a low prevalence was observed in the Tigray region (19.45%; 95% CI: 6.08, 32.82). Food handlers who had not taken food hygiene training (OR: 0.68, 95% CI: −0.34, 1.69), untrimmed finger nail (OR: 2.23, 95% CI: 1.47, 2.99), lack of periodic medical checkup (OR: 1.52, 95% CI: 0.41, 2.64), lack of handwashing habits (OR: 1.97, 95% CI: 0.53, 3.41), and eating raw vegetables and meat (OR: 2.63, 95% CI: 0.92, 4.34) were factors significantly associated with the prevalence of IPs and EBIs. The prevalence of IPs and EBIs was high in the selected Ethiopian region (Amhara, Oromia, SNNPR, and Tigray) food handlers along an increasing prevalence trend from 2014 to 2022. Therefore, this study recommends the provision of proper health education and training regarding personal hygiene, hand washing, food handling, medical checks, as well as raw vegetable and meat safety.

Prevalence and Associated Risk Factors of Human Intestinal Helminths Parasitic Infections in Ethiopia: A Systematic Review and Meta-Analysis

Background

Intestinal helminth infections are still public health problems in tropical and subtropical countries including Ethiopia. This review and meta-analysis aimed to produce the pooled prevalence and associated risk factors of human intestinal helminth parasitic infections (HIHPIs) in Ethiopia.

Methods

Articles written in English were searched from online databases. Sixty-seven studies were included. Meta-analysis was computed using STATA version 14.

Result

The pooled prevalence of HIHPIs was (33.35%, 95% CI: 28.85%, 37.86%). Ascaris lumbricoides (10.84%, 95% CI: 9.34, 12.34), hookworm spp. (8.89%, 95% CI: 7.75, 10.04), Schistosoma mansoni (4.22%, 95% CI: 3.64, 4.81), Trichuris trichiura (2.51%, 95% CI: 2.17, 2.86), Hymenolepis nana (2.29%, 95% CI: 1.96, 2.63), Taenia species (1.01%, 95% CI: 0.80, 1.22), Strongyloides stercoralis (1.17%, 95% CI: 0.92, 1.41), and Enterobius vermicularis(0.71%, 95% CI: 0.52, 0.90) were recorded. Handwashing before food (OR: 5.22,95% CI: 3.49, 6.94), handwashing after toilet (OR: 3.03, 95%; CI: 1.01, 5.05), age (OR: 1.66, 95% CL. 1.09, 2.23), open defecation (OR: 2.42, 95% CI: 1.60, 3.24), eating raw and unwashed vegetables/fruits (OR: 1.98, 95%; CI: 1.30, 2.66), maternal education (OR: 1.81, 95% CI: 0.91, 2.72), family income (OR: 2.00, 95% CI: 0.87, 3.31), source of drinking water (OR: 3.12, 95% CI: 1.96, 4.27), swimming/contact with river water (OR: 1.90, 95% CI: 1.11, 2.69), barefoot (OR: 3.28, 95% CI: 1.67, 4.88), playing with soil (OR: 2.64, 95% CI: 1.40, 3.88), and family size (OR: 3.75, 95% CI: 2.03, 5.46) were factors associated with HIHPIs in Ethiopia. High heterogeneity of the prevalence of HIHPIs was observed among the studies within and among regions (I² > 99.6% and P ≤ 0.001).

Conclusion

HIHPIs in Ethiopia were significantly high. Therefore, special attention should be given by all stakeholders to minimize HIHPIs in Ethiopia.

Predictors of Intestinal Parasites among Food Handlers in Goba Town, Southeast Ethiopia, 2020

Background

Globally, around 1.9 million people were dying due to food-borne diseases annually, and intestinal parasites infected one-third of the population, according to estimates and more prevalent in developing countries due to poverty. This study assessed predictors of intestinal parasites among food handlers working in Goba towns.

Methods

A laboratory-based cross-sectional study was conducted from October to December 2020. Clean, dry, and leak-proof stool cups were used to collect the samples. The SPSS version 20 computer software was used to enter and clean the data, code it, and analyze it. The researchers performed binary and multivariable logistic regression analyses, with a p value of 0.05 considered significant.

Result

A total of 98 (34%) of the 288 food workers tested positive for various intestinal parasites. Giardia lamblia was the most common parasite, with 42 (14.6%), followed by Entamoeba histolytica/dispar with 31 (10.8%), Ascaris lumbricoides with 8 (2.8%), Taenia species with 5 (1.7%), and E. vermicularis with 4 (1.4%). Six (2%) of the 98 positive food handlers had two infections. E. histolytica and G. lamblia were the most common parasites found in mixed infections. Hand washing with soap and water before handling food (AOR: 3.06, 95% CI: 1.16, 7.26) and untrimmed fingernail status (AOR: 2.3, 95% CI: 1.14, 4.34) were found to be strongly linked to intestinal parasite infection.

Conclusion

In this investigation, intestinal parasite species were found in 34% of stool samples. Independent predictors of intestinal parasite infection were fingernail status and hand washing with water and soap use before food handling. To control intestinal parasite infection among food handlers in the research area, personal hygiene and ambient cleanliness should be improved.

A population-based survey of the prevalence of self-reported acute gastrointestinal illness in Zhejiang Province, China

Acute gastrointestinal illness (AGI) is a prevalent public health concern worldwide. This study investigated the magnitude, distribution and burden of self-reported AGI among residents of Zhejiang Province, China. A face-to-face household survey was conducted using a multi-stage stratified random sampling method in 10 counties in Zhejiang Province between July 2018 and June 2019. In total, 12,021 participants were recruited. The prevalence of AGI 28 days after standardization was 1.8% (95% confidence interval (CI), 1.6–2.1), with an incidence rate of 0.24 episodes of AGI per person-year and an estimated 14 million cases of AGI in Zhejiang Province. Univariate and multivariable analyses showed a higher AGI prevalence among people who performed housework and were unemployed in summer and autumn among respondents living in western or northern cities (p < 0.05). More than 50% of AGI cases were attributed to the consumption of contaminated food. The disease burden caused by AGI in Zhejiang Province was approximately 975 million Chinses yuan (CNY). These results indicated that the disease burden of AGI in Zhejiang Province should be addressed and highlights the need for an improved active surveillance system of foodborne diseases to assess the impact of AGI on society and health.

Assessment of Intestinal Parasites, Enteric Bacterial Infections, and Antimicrobial Susceptibility among Street Food Handlers in Jimma Town, Southwest Ethiopia

Background

Food-borne infections are common public health problems worldwide. A street food handler with poor personal hygiene contributes to the transmission of intestinal parasites and enteric bacteria to the public via contaminated foods. In Ethiopia, health risks associated with street food are common. Previous studies in this area are scanty. Hence, the aim of this study was to determine the prevalence of intestinal parasites, enteric bacterial infections, and antimicrobial susceptibility among street food handlers in Jimma town.

Methods

A cross-sectional study was conducted from October to December 2020 among 260 street food handlers in Jimma town. A semi-structured questionnaire was used to collect data through face-to-face interviews. About 3 grams of the fecal specimen were collected from each food handler for bacterial culture and concentration techniques. The data were entered into Epi-Data 3.1 and analyzed by SPSS version 20. Associated factors were identified by using binary logistic regression analysis. A statistically significant association was determined at a p-value less than 0.05.

Results

The overall prevalence of intestinal parasites and enteric bacterial pathogens was 39.2% (33.3%–45.2%) and 8.85% (5.4%–12.3%), respectively. Ascaris lumbricoides (18.5%) and Salmonella (8.1%) were the most predominant parasite and enteric bacterial isolates, respectively. Not trimming fingernails (AOR = 2.884; 95% CI: 1.682–4.945) and not washing hands with soap after toilet (AOR = 3.342; 95% CI: 1.939–5.761) were factors associated with increased risk of infection by intestinal parasites or enteric bacterial pathogens. All Salmonella and Shigella isolates were 100% resistant to ampicillin.

Conclusion

The infection with intestinal parasites and enteric bacterial pathogens detected in this study indicated that street food handlers may serve as sources of pathogens/parasites for transmission and experience morbidities due to the infections. Therefore, periodic medical checkups and creating awareness of personal hygiene are mandatory to reduce the risk of infections.

Health and economic burden of foodborne zoonotic diseases in Amhara region, Ethiopia

Diseases from food of animal origin are common health problems in Ethiopia. A cross-sectional study was carried out to estimate health and economic burden, and to identify demographic factors associated with community awareness of foodborne zoonotic diseases in Amhara region, Ethiopia. Data was collected from 435 households in three towns: Gondar, Lalibela and Debark. A retrospective data was also collected from health records in each town. The health burden due to zoonotic diseases was estimated at 0.2, 0.1 and 1.3 DALYs per household per year and at 73.2, 146.6 and 1,689.5 DALYs out of 100,000 populations per year in Gondar, Lalibela and Debark, respectively. The overall health burden due to foodborne zoonotic diseases (aggregated over the 435 households in the three towns) was estimated to be 89.9 DALYs per 100,000 populations per year. The economic impact of foodborne zoonotic diseases in the three towns of Amhara regional state was 278.98 Ethiopian Birr (ETB) (1ETB = 0.025 US Dollar) per household per year and 121,355.68 ETB per year. Costs of preventive measures followed by costs of patients’ time made the highest contribution while costs of diagnosis made the lowest contribution to the total economic burden of foodborne zoonotic diseases. From a total of 435 respondents, 305 (70.1%) had known the presence of zoonotic diseases. Level of education, number of families in the house and income were highly associated with awareness of zoonosis. Although majority of respondents had known zoonotic diseases exists (70.1%) and disease can be acquired from animal source food (63.2%), the health and economic burden associated to foodborne zoonotic diseases are still high. Therefore, changing mindset and practical training aiming in controlling foodborne zoonotic diseases may be suggested to the community in the health improvement extension service.

A systematic review and meta-analysis on prevalence and distribution of Taenia and Echinococcus infections in Ethiopia

Background

Tapeworm infections are among the tropical neglected parasitic diseases endemically occurring in Ethiopia. This systematic review and meta-analysis aims at estimating the pooled prevalence and distribution of Taenia and Echinococcus infections in humans and animals from reports from Ethiopia.

Methods

The systematic search was conducted in four bibliographic databases (PubMed, Google Scholar, Africa Journal Online and Science Direct). Additional data were retrieved from grey literature. Studies that met the inclusion criteria were considered for the systematic review and meta-analysis. The meta-analysis was conducted using MetaXL add-in for Microsoft Excel. Heterogeneity and inconsistency were evaluated using Cochran’s Q and I² statistics, respectively.

Results

The study provides a country-based database of Taenia and Echinococcus infections consisting of 311 datasets from 201 publications which were mostly abattoir surveys; of these, 251 datasets were subjected to meta-analysis. Most of the studies were from Oromia (32.8%) followed by Amhara (22.9%) regional states. The pooled prevalence of cystic echinococcosis in intermediate and accidental hosts was calculated as 22% (95% CI 18–26%) and high study variability (Q = 24,420.65, I² = 100%, P = 0.000). Moreover, a pooled prevalence of Echinococcus infections in final hosts was calculated as 33% (95% CI 20–48%) and low study variability (Q = 17.24, I² = 65%, P = 0.001). Similarly, study subjects (human, cattle, sheep, goat and wolf) were infected by Taenia spp. with pooled prevalence of 3% (95% CI 2–4%) and moderate study variability (Q = 279.07, I² = 89, P = 0.000). Meanwhile, the pooled prevalence of Taenia hydatigena, T. ovis and T. multiceps infections in intermediate hosts were calculated as 38%, 14% and 5%, respectively. The random effect meta-analysis of bovine cysticercosis showed a pooled prevalence of 7% (95% CI 5–9%) and high study variability was of (Q = 4458.76; I² = 99%, P = 0.000). Significant differences in prevalence of Taenia and Echinococcus infections between study sites or different livestock origins have been reported.

Conclusion

The study evidenced a comprehensive dataset on the prevalence and distribution of Taenia and Echinococcus infections at different interfaces by regions and hosts and hence can aid in the design of more effective control strategies.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-04925-w.

Prevalence and epidemiological distribution of selected foodborne pathogens in human and different environmental samples in Ethiopia: a systematic review and meta-analysis

Bacterial Foodborne Pathogens (FBP) are the commonest cause of foodborne illness or foodborne diseases (FBD) worldwide. They contaminate food at any stages in the entire food chain, from farm to dining-table. Among these, the Diarrheagenic Escherichia coli (DEC), Non typhoidal Salmonella (NTS), Shigella spp. and Campylobacter spp. are responsible for a large proportion of illnesses, deaths; and, particularly, as causes of acute diarrheal diseases. Though existing studies indicate the problem may be severe in developing countries like Ethiopia, the evidence is commonly based on fragmented data from individual studies. A review of published and unpublished manuscripts was conducted to obtain information on major FBP and identify the gaps in tracking their source attributions at the human, animal and environmental interface. A total of 1753 articles were initially retrieved after restricting the study period to between January 2000 and July 2020. After the second screening, only 51 articles on the humans and 43 on the environmental sample based studies were included in this review. In the absence of subgroups, overall as well as human stool and environmental sample based pooled prevalence estimate of FBP were analyzed. Since, substantial heterogeneity is expected, we also performed a subgroup analyses for principal study variables to estimate pooled prevalence of FBP at different epidemiological settings in both sample sources. The overall random pooled prevalence estimate of FBP (Salmonella, pathogenic Escherichia coli (E. coli), Shigella and Campylobacter spp.) was 8%; 95% CI: 6.5-8.7, with statistically higher (P <  0.01) estimates in environmental samples (11%) than in human stool (6%). The subgroup analysis depicted that Salmonella and pathogenic E. coli contributed to 5.7% (95% CI: 4.7-6.8) and 11.6% (95% CI: 8.8-15.1) respectively, of the overall pooled prevalence estimates of FBD in Ethiopia. The result of meta-regression showed, administrative regional state, geographic area of the study, source of sample and categorized sample size all significantly contributed to the heterogeneity of Salmonella and pathogenic E. coli estimates. Besides, the multivariate meta- regression indicated the actual study year between 2011 and 2015 was significantly associated with the environmental sample-based prevalence estimates of these FBP. This systematic review and meta-analysis depicted FBP are important in Ethiopia though majority of the studies were conducted separately either in human, animal or environmental samples employing routine culture based diagnostic method. Thus, further FBD study at the human, animal and environmental interface employing advanced diagnostic methods is needed to investigate source attributions of FBD in one health approach.

Prevalence of Intestinal Parasite Infections and Their Associated Factors among Food Handlers Working in Selected Catering Establishments from Bule Hora, Ethiopia

Intestinal parasites are responsible for one of the major health problems like food contamination with socioeconomic effects in the world with a prevalence rate of 30-60%, in developing countries that lie within tropical and subtropical areas. They pose a reasonable public health burden, particularly in low- and middle-income countries, including Ethiopia. Globally, due to intestinal parasitic infections, around 3.5 billion people are affected and more than 200,000 deaths are reported annually. Around 50000 deaths yearly are caused by intestinal parasites in Ethiopia. As such, intestinal parasites perceived global and local burdens to various countries. The risk of food contamination depends largely on the health status of the food handlers, their hygiene, knowledge, and practice of food hygiene. Food handlers with poor personal hygiene and sanitation conditions are the major potential sources of intestinal helminthes and protozoa worldwide. The proposed study was aimed at evaluating prevalence of intestinal parasitic infections and their associated factors among food handlers working in selected catering establishments. A cross-sectional study was conducted in Bule Hora Town from March to April 2020. A total of 136 catering establishments were selected using a systematic sampling technique. Data analysis was done using SPSS version 20. The prevalence of intestinal parasites in this study was 46.3%. Entamoeba histolytica was the most predominant parasite (33.3%, i.e., 21/63) while Giardia lamblia was the least (11.1%, i.e., 7/63). Consumption of vended or borehole water and hygienic practices such as hand washing before eating, after using toilet, before cooking and trimming of finger nail and wearing proper working clothes and shoes were statistically significant with intestinal parasitic infection (P < 0.05). Generally, the prevalence of intestinal parasitic infection in this study was high and contributed by low socioeconomic status and poor environmental and personal hygiene. Measures including education on personal hygiene, environmental sanitation, drinking water supply, regular medical checkups, and treatment should be taken into account to reduce the prevalence of intestinal parasites.

Antibiotic susceptibility and genetic relatedness of Shigella species isolated from food and human stool samples in Qazvin, Iran

Objective

The aim of this study was to investigate the genetic relatedness and antimicrobial resistance among Shigella species isolated from food and stool samples. Using cross sectional study method, Shigella spp. were isolated from food and clinical samples using culture-based, biochemical and serological methods. Antimicrobial susceptibility and genetic relatedness among the isolates were evaluated using disk diffusion and RAPD-PCR methods respectively.

Results

The prevalence of Shigella spp. were 4.84 and 7.7% in food and stool samples respectively. All food isolates were Sh. sonnei. 91.42% of the Shigella stool isolates were Sh. sonnei. 62.5% of food isolates were resistant to tetracycline. 46.8, 50 and 65.8% of clinical isolates were resistant to imipenem, amikacin and azithromycin respectively. 50 and 85.7% of the food and clinical isolates respectively were MDR. Dendrogram generated by RAPD-PCR showed that the isolates from food and stool samples were categorized in a same group. Close genetic relatedness between MDR Shigella isolates from food and clinical samples indicate that foods can be considered as one of the main vehicles for transmission of MDR Shigella to human causing acute diseases. Survey of MDR Shigella among food and clinical samples is strongly suggested to be implemented.

Enteropathogenic Bacterial and Intestinal Parasitic Infections among Asymptomatic Food Handlers in Rangsit University Canteens, Central Thailand

Food handlers play an important role in the transmission of foodborne diseases. 108 asymptomatic food handlers work in RSU canteens and have never been checked for intestinal bacteria and parasites, which might be a potential source of infection for customers. This study is aimed at estimating the prevalence of enteropathogenic bacterial and intestinal parasitic infections among food handlers in Rangsit University canteens, central Thailand. A total of 79 food handlers were enrolled, and each provided one stool sample (response rate of 73.2%). Females comprised 93.7% of study participants, and the largest age group was 41-50 years (34.2%). The prevalence of enteropathogenic bacteria in stool cultures was 2.5%, and only Aeromonas spp. were detected. The pathogenic protozoa Giardia duodenalis was detected in 1.3% of samples, and nonpathogenic protozoa was found in 11.4%. No helminths were found in any samples. Approximately 80% of food handlers demonstrated good hygiene practices, including regular hand washing after visiting the toilet, regular hand washing when preparing food, using soap when washing hands, wearing uniforms/gowns, practicing correct hand washing techniques, and having short fingernails. However, the results showed a lack of personal hygiene training and routine medical care (>50% of samples). Stronger intervention would help to eliminate future infections.

Prevalence, Risk Factors, and Antibiogram of Nontyphoidal Salmonella from Beef in Ambo and Holeta Towns, Oromia Region, Ethiopia

Background

Salmonella has been recognized as a major cause of food-borne illness associated with the consumption of food of animal origin. The present cross-sectional study was conducted from December 2017 to May 2018 in Ambo and Holeta towns to assess the prevalence, risk factors, and antimicrobial susceptibility patterns of nontyphoidal Salmonella isolates from raw beef samples from abattoirs, butchers, and restaurants in Ambo and Holeta towns, Oromia region, Ethiopia.

Methods

A total of 354 beef samples were collected from abattoirs, butchers, and restaurants. Salmonella isolation and identification were carried out using standard bacteriological methods recommended by the International Organization for Standardization. Antimicrobial susceptibility testing was performed using the disk diffusion method. Besides, a structured questionnaire was used to collect sociodemographic data and potential risk factors for contamination of meat. Chi-square tests and logistic regression were used for data analyses.

Results

Of the total 354 meat samples examined, 20 (5.7%, 95% confidence interval (CI): 3.5–8.6) were positive for Salmonella. Two serotypes belonging to S. typhimurium (11 isolates) and I:4,5,12: i:- (9 isolates) were identified. The Salmonella detection rate in abattoirs, butchers, and restaurants was 4.2% (5/118), 8.5% (10/118), and 4.2% (5/118), respectively. The antimicrobial susceptibility test showed that 40%, 30%, and 20% of the Salmonella isolates were resistant to azithromycin, amoxicillin, and ceftriaxone, respectively. The odds of Salmonella isolation when meat handlers are illiterate were 7.8 times higher than those when they are educated to the level of secondary and above (P=0.032). Similarly, the likelihood of Salmonella isolation was 6.3 and 7.6 times higher among workers of butcher and restaurants, respectively, who had no training (P=0.003) and no knowledge (P=0.010) on food safety and hygiene.

Conclusions

The study showed widespread multidrug-resistant Salmonella isolates in the study areas. Therefore, raw meat consumption and indiscriminate use of antimicrobial drugs should be discouraged. Provision of food safety education for meat handlers and further surveillance of antimicrobial-resistant isolates are suggested.

Prevalence and Associated Factors of Intestinal Parasitic Infections among Food Handlers in Mettu Town, Southwest Ethiopia

Food handlers are important sources of intestinal parasitic infection to the public and mass catering service areas. Several reports worldwide particularly in developing countries showed a high prevalence of intestinal parasitic infections among these groups of individuals. In an attempt to determine the prevalence of intestinal parasites, a cross-sectional study was carried out among food handlers in food establishment areas of Mettu town, Southwest Ethiopia. To collect sociodemographic characteristics of the study participants, a structured questionnaire and physical observation were employed. Stool specimens collected from each food handlers participated in the study were then examined using light microscopy of the wet mount followed by formol-ether concentration methods to see infection status. A total of 139 food handlers were enrolled in the study. Majority of them were females 89 (64%), and 124 (89.2%) of them had not taken any training related to food handling and preparation. Sixty-two (44.6%) of the study participants were diagnosed with one or more intestinal parasites. The chi-square test showed that intestinal parasite infection was found associated with personal hygiene (p ≤ 0.0001), nail trimming status (p ≤ 0.0001), and hair cover status (p ≤ 0.040). The multivariable logistic regression indicated that the risk to be infected with intestinal parasites were related with older age (p ≤ 0.032), food handlers who had no hand wash practices (p ≤ 0.033), who had no food handling and preparation training (p ≤ 0.005), poor personal hygiene (p ≤ 0.0001), who had not taken regular medical checkup (p ≤ 0.008), and whose nail was not trimmed (p ≤ 0.0001). The most abundant intestinal parasite identified was G. lamblia (24, 26.7%) followed by E. histolytica/dispar (22, 24.4%), and A. lumbricoides (15, 16.7%). Twenty-eight (45.2%) study individuals were also found with mixed infections. The study thus revealed a high prevalence of intestinal parasitic infection among apparently healthy food handlers in food establishments of the study area. Mass drug administration for all food handlers working in food establishment areas of the town coupled with health education and training should be initiated urgently.

Prevalence of Intestinal Parasites and Salmonella typhi among Food Handlers Working in Catering Establishments of Public Institutes Found in Dawuro Zone, South-Western Ethiopia

Background

Food borne disease, which is the result of ingestion of foodstuffs contaminated with microorganisms, parasites, or chemicals, encompasses a wide spectrum of illness and public health problem worldwide. Ethiopia is placed on second, third, and fourth position due to the highest burden of ascariasis, hookworm, and trichuriasis, respectively, in sub-Saharan Africa. The present study is aimed at determining the prevalence of Salmonella typhi and intestinal parasites among food handlers working in catering establishments of public institutes found in Dawuro Zone, South-Western Ethiopia.

Methods

A cross-sectional study is conducted among food handlers working in catering establishments of public institutions found in Dawuro Zone from March to July 2019. The data was collected by using pretested structured questionnaires. Stool and blood samples were taken from each participant for parasitic examinations concurrently using direct and modified formol ether concentration wet smear techniques and Widal test by slide test and tube serial dilution technique, respectively. The data entered into Epi info version 3.5.1 and then exported into SPSS window version 20.0 for analysis. Logistic regressions were performed to assess the association between binary outcomes and different explanatory variables. P value <0.05 was considered statistically significant.

Result

The study included 402 (293 females and 109 males) food handlers. Of 402 stool specimens, 20.4% were found to be positive for different parasite species, comprising protozoa (35.9%) and helminths (64.1%). A. lumbricoides was the most prevalent parasite (8.0%), followed by E. histolytica/dispar (4.23%). Twenty-six (6.5%) of food handlers were positive for Widal test. Ages ≥ 40 years (AOR: 0.436; 95% CI: 0.203, 0.937), attending no education (AOR: 2.142; 95% CI: 1.048, 4.378), not washing hands after using latrine (AOR: 4.355; 95% CI: 1.771, 10.708), not covering mouth with tissue paper (AOR: 0.530; 95% CI: 0.312, 0.899), no medical checkup (in the last four months) (AOR: 0.278; 95% CI: 0.116, 0.667), and untrimmed fingernails (AOR: 0.382; 95% CI: 0.229, 0.635) were significantly associated with intestinal parasitic or Salmonella typhi infections.

Conclusion

The prevalence of intestinal parasitic infection (IPI) and Salmonella among food handlers in the present study is relatively high compared to other different studies conducted in developed and developing countries. Therefore, biannually screening of food handlers for intestinal parasites (IPs) and periodic deworming of infected cases along with provision of food safety measures focusing on personal hygiene and environmental sanitation are recommended to control the parasitic infection in food handlers.

Prevalence and antimicrobial resistance patterns of Salmonella isolates in human stools and animal origin foods in Ethiopia: A systematic review and meta-analysis

OBJECTIVE

Foodborne diseases caused by non-typhoid Salmonella and the emergence of antimicrobial resistance remain as a public health challenge, especially in developing countries. The current study aimed to estimate the pooled prevalence and the antimicrobial resistance patterns of non-typhoid Salmonella in Ethiopia.

METHODS

Literature search was conducted from major electronic databases and indexing services. Both published and unpublished studies addressing the prevalence and antimicrobial resistance profiles of Salmonella in Ethiopia from 2010 to 2020 and those studies reported sample size and the numbers of isolates/number of positive samples were included in the study. Data were extracted using format prepared in Microsoft Excel. The identified data were exported to EndNote to remove duplicated studies, then after the remained articles were screened using title, abstract, and full text to identify studies that meet the inclusion criteria and finally appraised for methodological validity using JBI guideline. The pooled prevalence of Salmonella and its drug resistance pattern was computed by a random-effects model. I2 test statistic was used to test heterogeneity across studies. The presence of publication bias was evaluated using the Begg's and Egger's tests.

RESULTS

A total of 49 eligible articles, 33 of them on human stools, 15 of them on animal origin foods, and one both on human stools and animal origin foods, were included in the study. The pooled prevalence of Salmonella among human stools and animal origin foods in Ethiopia was 4.8% (95% CI: 3.9, 5.9) and 7.7% (95% CI: 5.6, 10.4), respectively. The subgroup analysis detected high pooled prevalence, 7.6% (95% CI: 5.3, 10.7) among outpatients and low, 3.7% (95% CI: 2.6, 5.1) in food handlers. The pooled resistant level of Salmonella was 80.6% (95% CI 72.6, 86.7) for ampicillin and 63.5% (95% CI 53.7, 72.4) for tetracycline. Low pooled resistance pattern was reported in ciprofloxacin, 8.7% (95% CI 5.6, 13.3) and ceftriaxone 12.2% (95% CI 7.9, 18.3). There was some sort of publication bias.

CONCLUSION

High pooled prevalence of Salmonella among human stools and animal origin foods which were 4.8% and 7.7% respectively, and high Salmonella resistance, >72% to ampicillin and tetracycline were detected in Ethiopia. Antimicrobial stewardship efforts and infection control strategies are required to mitigate this major public health concern.

Intestinal parasitic infection among foreign housemaids in northwestern Saudi Arabia: A cross-sectional study

Owing to Saudi Arabia's high-income economy many Saudi families hire foreign housemaids. However, since the housemaids are potential carriers of intestinal parasites, hiring them increases the risk of transmission to the Saudi community. In this context, this study aimed to evaluate the prevalence of intestinal parasitic infections in foreign housemaids in northwestern Saudi Arabia. Using direct wet mount and concentration by flotation, the stool samples of 169 housemaids were examined, and eleven parasite species, six helminths and five protozoans, were detected. The overall prevalence of intestinal parasitic infection was 20.11% (34/169). Twelve cases were infected with one intestinal helminth, 12 were infected with one intestinal protozoan, and 10 had polyparasitism. The most common intestinal parasites were Cryptosporidium spp. (n = 10), hookworms (n = 7), and T. Trichiura (n = 7). The findings highlight that intestinal parasites present an important public health concern for foreign housemaids in Saudi Arabia. More vigilance is thus required, and periodic follow-up should be exercised throughout foreign housemaids' stay in the country.

Bacterial Load Assessment of some Food Items Sold in Street in Woldia Town, North-East Ethiopia

Infectious diseases due to contaminated street vended food items has happened to an essential concern and public health issue in low socio-economic status individuals. The goal of this study was to evaluate bacterial quality and safety of some food items sold in street based on aerobic mesophilic bacteria, Salmonella, Staphylococcus aureus and Escherichia coli in Woldia town. Cross-sectional study was performed on some selected street vended foods from March 2019 to May 2019 in Woldia town. A total of 36 ready-to-eat food samples such as ‘Sambussa’, ‘Bonbolino’ and ‘Ambasha’ were collected for microbial analysis. Finding of the study indicates that 32(88.9 %) of the vendors were females, 28(77.7%) handled food with bare hands, 28(77.7%) vendors were washing their hands after toilet. The mean total count of aerobic mesophilic bacteria, Salmonella, Staphylococcus aureus and Escherichia coli was 4.5×102±5.2×101 CFUg-1, 1.5×102±4.5×101 CFUg-1, 1.1×102±1.4×101 CFUg-1 and 2×102±3.4×101 CFUg-1, respectively. The dominant bacterial isolate from the street vended foods was Escherichia coli (53.5%), followed by Salmonella (24.1%) and Staphylococcus aureus (22.4%). The result of this study demonstrates the non hygienic practices of the vendors in street vended foods showed high bacterial load. Therefore, the street vended foods were contaminated with food borne pathogenic bacteria that can create a potential risk to public health in the study area. In general, the bacterial quality of the food quality sold in street in Woldia town was very poor and needs especial attention to avoid bacterial contamination.

Prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among food handlers in Adigrat University student's cafeteria, northern Ethiopia, 2018

BACKGROUND

Food handlers play a significant role in the transmission of foodborne infections. Salmonella and Shigella are the most common foodborne pathogens and their infections are a major public health problem globally. Thus, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated factors of Salmonella and Shigella colonization among food handlers.

METHODOLOGY

A cross-sectional study was conducted from March to August 2018 at Adigrat University student cafeteria, Northern Ethiopia. Data on socio-demographic and associated factors were collected using a structured questionnaire. Fresh stool samples were collected from 301 food handlers and transported to Adigrat University Microbiology Laboratory. Bacterial isolation and antimicrobial susceptibility test were performed using standard bacteriological methods. Data analysis was performed using SPSS version 22 and P < 0.05 where a corresponding 95% confidence interval was considered statistically significant.

RESULTS

A total of 301 food handlers were included in this study. The majority of study participants were females 265 (88.0%). About 22 (7.3%) and 11 (3.7%) of food handlers were found to be positive for Salmonella and Shigella respectively. Hand washing after using a bathroom with water only, no hand washing after using the bathroom, no hand washing after touching dirty materials, no hand washing before food handling, and untrimmed fingernails were significant associated factors identified. None of the Salmonella and Shigella isolates were sensitive to ampicillin, yet low resistance against chloramphenicol, ceftriaxone, and ciprofloxacin was found.

CONCLUSION

The present study revealed that the prevalence of Salmonella and Shigella among food handlers was 22 (7.3%) and 11 (3.7%) respectively. Such colonized food handlers can contaminate food, and drinks and could serve as a source of infection to consumers. This indicates that there is a need for strengthened infection control measures to prevent Salmonella and Shigella transmission in the students' cafeteria.

Identification of risk areas and practices for Taenia saginata taeniosis/cysticercosis in Ethiopia: a systematic review and meta-analysis

Background

Bovine cysticercosis (BCC) is an infection of cattle with the metacestode stage of Taenia saginata, the beef tapeworm, which causes taeniosis in humans. BCC is responsible for considerable economic losses in the meat sector worldwide. This systematic review and meta-analysis summarizes the prevalence, risk factors and treatment efforts made so far on T. saginata infections in Ethiopia, providing a detailed analysis of different factors influencing the varying prevalence estimates in Ethiopia to gain more insight into the occurrence and risk factors of T. saginata taeniosis and cysticercosis to date.

Methods

A systematic review and meta-analysis was conducted on data collected from published and grey literature accessed through an electronic database and manual search.

Results

The literature search resulted in 776 outputs of which 132 conformed to the predefined criteria. The average zonal prevalence of meat inspection-based BCC ranged from 2% in Buno-Bedele to 24.6% in Sidama zone. The pooled prevalence of BCC was influenced by the number of muscle/organs inspected, ranging from 3.4% (95% CI: 1.7–5.1%) using fewer predilection sites to 19.4% (95% CI: 13.3–25.4%) using inspection of a maximum number of predilection sites. None of the tested variables were significantly associated with BCC. Questionnaire-based taeniosis ranged between 19.0% in Halaba special woreda to 70.0% in Gedeo zone and stool test-based taeniosis varied from 0.6% in central Tigray to 10.7% in Gurage zone. Questionnaire-based prevalence of taeniosis was higher in people with a frequent raw beef consumption habit (pooled OR, pOR: 10.5, 95% CI: 6.0–17.9), adults (pOR: 2.5, 95% CI: 1.7–3.6), men (pOR: 2.8, 95% CI: 2.1–3.6), and Christians (pOR: 2.0, 95% CI: 1.4–2.8) compared to less frequent raw beef consumers, younger people, women and Muslims, respectively.

Conclusions

This review revealed a widespread but variable occurrence of BCC and taeniosis in Ethiopian regions and zones, urging for harmonized and enhanced detection for improved control of the parasite. Accurate prevalence estimates using more sensitive tests, detailed risk factor analysis, as well as data on financial losses are needed to develop effective control strategies for the Ethiopian epidemiologic condition.

Review on Major Food-Borne Zoonotic Bacterial Pathogens

Food-borne microorganisms are major pathogens affecting food safety and cause human illness worldwide as a result of consumption of foodstuff, mainly animal products contaminated with vegetative pathogens or their toxins. Most of these microbes have zoonotic importance resulting in significant impact on both public health and economic sectors. Bacteria are the causative agents of two-thirds of human food-borne diseases worldwide with high burden in developing countries. Hence, the objectives of this review paper are to highlight the background of food-borne bacterial pathogens and to review common major food-borne zoonotic bacterial pathogens. Food animals are the major reservoirs of many food-borne zoonotic bacterial pathogens, and food products of animal origin are the main vehicles of transmission. Meat, dairy products, and eggs are the main ways by which people are exposed to zoonotic bacteria. S. aureus, Salmonella species, Campylobacter species, L. monocytogenes, and E. coli are the major zoonotic bacterial pathogens which are the causative agents of food-borne illness and death in the world associated with consumption of contaminated animal products. Production of toxins and structural virulent factors are responsible for the pathogenesis of these bacteria. These major zoonotic bacteria cause human infections which are characterized mainly by gastrointestinal symptoms including nausea, vomiting, diarrhea, abdominal cramps, and other agent-specific symptoms. Some bacteria may cause severe complications. Conventional (culturing), serological, and molecular techniques are important for detection of these common zoonotic bacteria and their toxins in food. Good hygiene, GMP, sanitation in operating procedures, and implementation of standardized HACCP and pasteurization procedures are effective methods for the control and prevention. Currently, the emergence of multidrug-resistant zoonotic bacteria associated with consumption of contaminated animal products is a great concern for the public health, and there should be coordinated surveillance and monitoring system for food-borne zoonotic bacterial pathogens particularly in developing countries including Ethiopia.

Prevalence and Antimicrobial Resistance Pattern of Salmonella, Shigella, and Intestinal Parasites and Associated Factor among Food Handlers in Dilla University Student Cafeteria, Dilla, Ethiopia

BACKGROUND

Food-borne disease is mostly caused by unsafe food handling and processing as well as poor hygienic practice. Recently, it is a worldwide and local burden to the human health. It is estimated that about one-third of the world population is affected by food-borne diseases annually and become a global public health problem. Hence, this study aimed to determine the prevalence, antimicrobial susceptibility patterns, and associated risk factors of Shigella, Salmonella, and intestinal parasites among food handlers in Dilla University, Southern Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted from November to September 2018/2019. A structured questionnaire was used for the collection of data on sociodemographic characteristics. Parasite and bacterial identification, as well as susceptibility testing, was done using standard parasitological and bacteriological procedures.

RESULTS

Of the total 220 food handlers included in the study, 38.6%, 9.5%, and 3.2% were positive for intestinal parasites, Salmonella, and Shigella species, respectively. A. lumbricoides (11.4%) was the predominant parasite isolated followed by E. histolytica (7.7%). From the total Salmonella isolates, serogroup D was the most frequent isolate and from the total Shigella species, Shigella flexneri was the predominant isolate. In this study, through irregular medical checkups, those who drunk unpasteurized milk and ate raw meat were significantly associated with intestinal parasites. Both Salmonella and Shigella species were highly resistant to ampicillin (81%) and amoxicillin-clavulanic acid (>70%). Salmonella isolates are highly sensitive to cefotaxime and ceftriaxone, while Shigella is highly sensitive to ciprofloxacin and norfloxacin. MDR was recorded in 71.4% of all bacterial isolates.

CONCLUSION

The presence of a high prevalence of intestinal parasites, Salmonella, and Shigella species that were resistant to the commonly prescribed drugs is a treat to the children and the community at large. Therefore, measures including health education, improvement of safe water supply, sanitation facilities, and continuous monitoring of microbiological and antimicrobial surveillance are crucial.

Prevalence and Associated Risk Factors of Salmonella, Shigella, and Intestinal Parasites among Food Handlers in Motta Town, North West Ethiopia

Background

Intestinal parasite, Salmonella, and Shigella infections are the main public health concerns in the world, especially in developing countries due to inaccessibility of safe water and unhygienic food handling practices of food handlers.

Methods

A cross-sectional study was conducted in food handlers in Motta town, from February 2019 to April 2019. The study was undertaken to determine the prevalence and associated risk factors of Salmonella, Shigella, and intestinal parasites among 243 food handlers. Sociodemographic and risk factors were collected using pretested structured questionnaire. The stool sample was collected and examined with direct wet mount and concentration techniques. Culture was performed using xylose lysine deoxycholate agar and MacConkey agar and biochemical tests like Klinger iron agar (KIA), lysine iron agar (LIA), Simmons citrate agar, sulphide indole motility test, citrate utilization, and urease production test were conducted to isolate Salmonella species and Shigella species. An antibiotics susceptibility test was performed with Mueller-Hinton agar using the disk diffusion method. Data were entered using statistical package Epi-Data Version 3.1 and analysed with logistic regression using SPSS version 25 and Fisher's exact test. A p value < 0.05 at 95% CI was considered as statistically significant.

Results

The prevalence of intestinal parasite, Salmonella, and Shigella was 27.6%, 2.5%, and 1.6%, respectively, and hookworm was the predominant intestinal parasite detected in the stool. Antimicrobial resistance was observed in ampicillin and tetracycline (100%) in Salmonella species and Shigella species. Risk factors like fingernail status, fruit washing before eating, cleaning utensils, and regular shoe wearing habit were associated with intestinal parasite, whereas fingernail status and wearing kitchen gown during food service were significantly associated with Salmonella and Shigella infections.

Conclusion

The prevalence of intestinal parasitic infections, Salmonella, and Shigella infections in this study indicates the importance of food handlers as probable sources of enteropathogenic infections. Food handlers should have follow-up on the order of food safety rules and keep their personal hygiene. Hotel owners are responsible to control the health status and their created awareness by given food hygiene training for food handlers. Therefore, policy-makers and implementers should focus on the risk factors to reduce the prevalence below the level of public health importance.

Prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Intestinal infection is still an important public health problem in low-income countries. Food handlers may be infected by a wide range of enteropathogens and have been implicated in the transmission of many infections to the public. Therefore, the aim of this review was to produce the pooled prevalence and factors associated with intestinal parasitic infections among food handlers working at higher public University student's cafeterias and public food establishments in Ethiopia.

METHODS

Articles published in PubMed/Medline, Hinari, Web of Science, Science Direct, and Google Scholar were used using a search strategy. Observational studies (cross-sectional) revealing the prevalence and factors associated with intestinal parasitic infections at higher public University student's cafeterias and public food establishments were incorporated. Meta-analysis was computed using STATA version 14 statistical software. Heterogeneity of the study was assessed using Cochrane Q test statistics and I2 test. The pooled prevalence of the intestinal parasitic infection and associated factors among food handlers was calculated by the random-effect model.

RESULTS

Out of 138 reviewed studies, 18 studies were included to estimate the pooled prevalence of intestinal parasitic infections among food handlers in Ethiopia. All the eighteen articles were included in the analysis. This study revealed that the pooled prevalence of intestinal parasitic infections was 28.5% (95% CI: 27.4, 29.7). E. hystolitica /E. dispar complex 6.38 (95% Cl: 5.73, 7.04), A.lumbricodes 4.12 (95% Cl: 3.56, 4.67), and G. lamblia 3.12(95% Cl: 2.65, 3.60) were the most common intestinal parasitic infections in this study. Untrimmed fingernail 3.04 (95% CI: 2.19, 4.22), do not washing hands after defecation 2.71 (95% CI: 1.93, 3.82), do not washing hands after touching any body parts 2.41 (95% CI: 1.64, 3.56), do not made medical checkup 2.26 (95% CI: 1.57, 3.25), and do not receive food safety training 1.79 (95% CI: 1.30, 2.45) were factors significantly and positively associated with intestinal parasitic infections.

CONCLUSION

Parasitic infections among food handlers were significantly high. Untrimmed fingernail, do not washing hands after defecation, do not washing hands after touching any body parts, do not made regular medical checkup and do not receive food safety training were factors that increase the prevalence of intestinal parasitic infections.

Predictors of Intestinal Parasitic Infection among Food Handlers Working in Madda Walabu University, Ethiopia: A Cross-Sectional Study

Background

Intestinal parasitic infection is one of the major health problems globally. It is more common in developing countries including Ethiopia. So, adequate evidence is needed regarding the predictors of intestinal parasitic infection. This study was aimed at determining the predictors of intestinal parasitic infection among food handlers working in Madda Walabu University, Ethiopia.

Methods

An institution-based cross-sectional study was conducted from 15 May to 10 June 2017 among 198 symptom-free food handlers. Data on sociodemographic variables were collected through face-to-face interview using a structured questionnaire. Stool samples were collected immediately after the interview using labeled wide-mouthed plastic container and clean wooden applicator. Direct wet-mount method and formal-ether concentration techniques were performed to identify intestinal parasites. The data were analyzed using SPSS version 21.0. Descriptive statistics and crude and adjusted odds ratios with 95% confidence interval (CI) were calculated. p value of <0.05 was considered to declaration level of significance.

Result

The response rate was 98% (198/202). The overall prevalence of intestinal parasites was 25.3% (50/198). The top three intestinal parasites found in this study were Ascaris lumbricoides 7.6% (15/198), Entamoeba histolytica/dispar 7.6% (15/198), and hookworm 5.6% (11/198). Inadequate handwashing practice (AOR: 13.876; 95% CI: 4.129, 46.632), inadequate knowledge about foodborne diseases (AOR: 3.596; 95% CI: 1.438, 8.989), lack of training on proper food handling (AOR: 5.960; 95% CI: 1.450, 24.497), and untrimmed fingernail (AOR: 2.939; 95% CI: 1.368, 6.135) were independent predictors of intestinal parasitic infection.

Conclusion

High prevalence of intestinal parasites was observed among symptom-free food handlers who could be unobservable source of disease transmission. Inadequate handwashing, untrimmed fingernail, inadequate knowledge, and lack of training were independent predictors of intestinal parasitic infection in this study. This implies the need for timely and adequate training and enforcement of regular medical checkup system for food handlers.

Intestinal parasites among food handlers of food service establishments in Ethiopia: a systematic review and meta-analysis

Background

Intestinal parasites remain considerable public health problems in low-income countries where poor food hygiene practice is common. Food handlers, people involved in preparing and serving food, working with poor personal hygiene could pose a potential threat of spreading intestinal parasites to the public in a community. The aim of this systematic review and meta-analysis was, therefore, to synthesize the pooled prevalence estimate of intestinal parasites and associated pooled odds ratio of hygienic predictors among food handlers of food service establishments in Ethiopia that could aid to further bringing down the burden of intestinal parasites and it can also be used as a springboard for future studies.

Methods

We searched exhaustively for studies Published before 20 April 2019 using eight Databases; PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and Ovid MEDLINE® complemented by the gray literature search. In the final synthesis, we included twenty study reports. We used the Cochrane Q test and I² test to assess heterogeneity of studies, while we employed a funnel plot followed by Egger’s regression asymmetry test and Begg rank correlation methods to evaluate publication bias. We also performed a point estimates and 95% confidence interval for each study using STATA version 14 statistical software.

Results

The overall pooled prevalence estimate of intestinal parasites among food handlers of food service establishments in Ethiopia was 33.6% (95%CI: 27.6–39.6%). Among ten intestinal parasites identified from food handlers, Entamoeba histolytica/ dispar (11, 95%CI: 7.9–14.1%) and Ascaris lumbricoides (8.8, 95%CI: 6.4–11.2%) were the most predominant intestinal parasites. Food handlers who washed hands after toilet use had 54% (OR, 0.46, 95% CI: 0.23–0.94) protection from intestinal parasites compared to those who did not.

Conclusions

This study revealed that intestinal parasitic infections are notable among food handlers of food service establishments in Ethiopia, which may be a risk for transmitting intestinal parasites to food and drinks consumers through the food chain. Thus, periodic stool checkup, training on intestinal parasitic infections and personal hygiene should be applied to reduce public health and socio-economic impacts of parasitic infections.

Magnitude of intestinal parasitic infections and associated factors among food handlers working at Woldia University student's cafeteria, Northeastern Ethiopia: an institution based cross-sectional study

Objectives

The main aim of this study was to assess the Magnitude of intestinal parasitic infections and associated factors among food handlers working at Woldia University Student’s cafeteria, Northeastern Ethiopia. Institutional based cross-sectional study was conducted among 256 study participants in Woldia university student’s cafeteria, Northern Ethiopia. Systematic random sampling method was used to select the study participants. Data was collected using a standardized questionnaire by direct interviewing of study participants. Logistic regression was carried out to identify factors associated with intestinal parasitic infections.

Results

A total of 256 food handlers were enrolled making the overall magnitude of the intestinal parasite which was stool specimens positive for different diagnostic stages of parasites was found to be 43 (16.8%). Entamoeba histolytica/dispar was the most prevalent parasites 14 (5.5%), followed by Giardia lamblia 10 (3.9%). Lack of food safety training (AOR = 6.58; 95% CI 2.46–17.62), no regular medical checkup (AOR = 2.41; 95% CI 1.47–4.24), no handwashing practice after toilet by soap (AOR = 3.24; 95% CI 1.28–8.19), no handwashing practice before eating by soap (AOR = 4.03; 95% CI 1.64–9.91) and haven’t food preparation license (AOR = 6.13; 95% CI 2.18–17.22) were significantly associated with parasitic infection among food handlers.

Prevalence and antimicrobial susceptibility profile of Salmonella and Shigella among food handlers working in food establishment at Hawassa city, Southern Ethiopia

OBJECTIVE

The aim of this study was to determine the prevalence of Salmonella and Shigella, antibiotic susceptibility profile and associated factors among food handlers working in food establishment from June to December 2018 at Hawassa city, Southern Ethiopia.

RESULTS

Out of the 236 food handlers screened for stool culture, 5 (2.12%) were positive for Salmonella species and all of them were negative for Shigella species. All Salmonella species isolated were susceptible to ciprofloxacin and ceftriaxone but among the five isolated Salmonella species, 4 (80%), 3 (60%), 2 (40%), 2 (40%), and 2 (40%) were resistant to tetracycline, ampicillin, amoxicillin-clavulanic acid, cotrimoxazole, and chloramphenicol respectively. Only food handlers hand washing the habit after toilet had a significant association with the prevalence of Salmonella species (P = 0.03).

Magnitude of enteropathogens and associated factors among apparently healthy food handlers at Wolkite University Student's Cafeteria, Southern Ethiopia

Objective

The study aimed to assess enteropathogens carriage rate and risk factors among apparently healthy food handlers at Wolkite University cafeteria, Southern Ethiopia.

Results

Cross-sectional study was conducted among 170 food handlers to collect socio-demographic and related data by using structured questionnaires. Stool samples were collected and subjected to microscopic examination and cultured to determine intestinal parasites. Among the total study participants, 66% of them were found to be carriers of enteropathogens: bacteria (Salmonella typhi, Shigella species), and intestinal parasites (Ascaris lumbricoides,Taenia species, Giardia lamblia, Entameoba histolytica/dispar, Enterobius vermicularis, Hook worm and Trichuris trichiura). All Salmonella and Shigella isolates were sensitive to ceftriaxone, ciprofloxacin, and gentamicin. A significant association was found between hand washing practice before food preparation and isolated pathogens [p = 0.013]. A significant proportion of food handlers were found to be carriers of pathogens which require a periodic screening and antibiotic therapy monitoring.

Prevalence of enteric bacteria and their antimicrobial susceptibility patterns among food handlers in Gondar town, Northwest Ethiopia

Background

Enteric bacterial pathogens are the major causes of food-borne gastroenteritis in humans and remain important public health problems worldwide. The emergence of antimicrobial resistance is a global concern, particularly in developing countries. The aim of this study was to determine the prevalence of enteric bacteria pathogens and their antimicrobial susceptibility patterns among food handlers in Gondar town, Northwest Ethiopia.

Methods

A cross-sectional study was conducted from February 4 to April 16, 2018. A total of 257 food handlers were selected using a multistage sampling technique. Data on socio-demographic characteristics were collected using a structured questionnaire. Stool samples were collected and inoculated into appropriate media. Enteric bacterial pathogens were identified using standard microbiological methods. Antimicrobial susceptibility tests were performed using the disk diffusion technique as per the standard Kirby-Bauer method. Data were entered and analyzed using SPSS version 20 software.

Results

The overall prevalence of enteric bacteria was 34/257 (13. 2%, [95% CI, 8.9-17.5%]). Shigella species was the leading isolate that accounted for 26/257 (10.1%) followed by Enterohemorrhagic Escherichia coli (EHEC) O157: H7 5/257 (1.9%) and Salmonella species 3/257 (1.2%). Shigella spp. was susceptible to ciprofloxacin 26 (100%), ceftriaxone 25 (96.1%), chloramphenicol 24 (92.3%), nalidixic acid 24 (92.3%), and gentamicin 20 (76.9%). Escherichia coli O157: H7 and Salmonella spp. showed the maximum (100%) susceptibility results to ceftriaxone, chloramphenicol, ciprofloxacin, and gentamicin. The overall prevalence of Multidrug resistance (MDR) in the current study was 14/34 (41.2%).

Conclusion

Our study showed high prevalence of enteric bacterial pathogens among food handlers. All isolates were susceptible to ciprofloxacin. However, a substential number of isolates were resistant to commonly prescribed antibiotics and the prevalence of MDR was high.

Prevalence of Shigella species and its drug resistance pattern in Ethiopia: a systematic review and meta-analysis

Background

Shigella species are a major cause of dysentery and may attribute for death worldwide. Currently antibiotic resistance became the critical challenges for management of infectious disease. The aim was to conduct a systematic review and meta-analysis of Shigella species and its drug resistance pattern in Ethiopia.

Methods

A comprehensive literature search was conducted through internet searches using database of MEDLINE, PubMed, Google scholar, EMBASE, HINARI, Cochrane Library and reference lists of previous prevalence studies from January 1999 to November 2018. Results were presented in forest plot, tables and figures with 95% CI. The Cochrane Q test and I² test statistic were used to test heterogeneity across studies. The Pooled estimate of Shigella species and its drug resistance pattern was computed by a random effects model.

Results

The pooled prevalence of Shigella species in Ethiopia was 6.6% (95% CI 4.7–8.8). In the subgroup analysis, the highest prevalence was observed among patients in Health facility (8.5%, 95% CI 6.2–11.5) whereas the lowest prevalence was observed in Community based studies (1.6%, 95% CI 0.8–3.4). In addition, Shigella species were highly resistant to ampicillin, amoxicillin, erythromycin and multi-drug resistant (MDR) with the pooled resistance proportions of 83.1% (95% CI 75.7–88.6), 84.1% (95% CI 75.6–90.1), 86.5% (95% CI 70.9–94.4) and 83.2% (95% CI 77.1–87.9), respectively. On the other hand, comparably low resistance pattern was reported for ciprofloxacin 8.9% (95% CI 6.0–12.8), ceftriaxone 9.3% (95% CI 3.9–20.5), and norfloxacin 8.2% (95% CI 3.8–16.6) and gentamycin 17.3% (95% CI 11.2–25.9). Subgroup analyses indicated that study years were associated with a decreasing Shigella prevalence over time (p = 0.002).

Conclusion

The pooled estimate showed high burden of Shigella infection and its high proportion of drug resistance pattern to ampicillin, amoxicillin and erythromycin in Ethiopia. Therefore, initiating and scale up of performing drug susceptibility test for each shigellosis case, educate the community and health care providers on appropriate use of antibiotics need to be considered and strengthened.

Electronic supplementary material

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Salmonella and Shigella Among Asymptomatic Street Food Vendors in the Dire Dawa city, Eastern Ethiopia: Prevalence, Antimicrobial Susceptibility Pattern, and Associated Factors

BACKGROUND

Salmonella and Shigella infections are a common public health problem throughout the world. The risk of getting infections is high, where asymptomatic street food vendors are preparing foods and vending. Current knowledge of antimicrobial susceptibility pattern is essential for appropriate treatment and management of these infections.

OBJECTIVE

This study was aimed to determine the prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among asymptomatic street food vendors in the Dire Dawa city, Eastern Ethiopia.

METHODS

A cross-sectional study was conducted among 218 randomly selected asymptomatic street food vendors in the Dire Dawa city, Eastern Ethiopia from May to July 2017. Data on the sociodemographic and associated factors were collected using a pretested structured questionnaire. The stool specimens collected were examined for Salmonella and Shigella using recommended culture methods. The antimicrobial susceptibility test was done using the disk diffusion technique. Data were described using descriptive statistical tools. Logistic regression models were used to identify the factors associated with Salmonella and Shigella infections. A P-value ⩽ .05 was considered statistically significant.

RESULTS

The overall prevalence of Salmonella and Shigella was 8.7% (95% confidence interval: 5.6, 10.3). The most common isolates were Salmonella (6%). Most of the isolates were resistant to amoxicillin (97.7%), ampicillin (89.5%), and tetracycline (68.4%). Almost half (47.4%) of Salmonella isolates were multidrug resistant. Food vendors who did not wash hands with soap after the use of the toilet (adjusted odds ratio: 3.3, 95% confidence interval: 1.2, 7.9), and who had untrimmed fingernails (adjusted odds ratio: 4.4, 95% confidence interval: 1.5, 9.3) had higher odds of Salmonella and Shigella compared with their counterparts.

CONCLUSIONS

The carrier rate of Salmonella and Shigella was relatively low. Most isolates have developed resistance to amoxicillin, ampicillin, and tetracycline. The odds of Salmonella and Shigella was high among those who lack a habit of hand washing with soap after the use of the toilet and with untrimmed fingernails. Regular screening and appropriate hygienic control measures are needed in place to reduce the risk of infections.

Prevalence of feco-oral transmitted protozoan infections and associated factors among university students in Ethiopia: a cross-sectional study

Background

An estimated 60% of the world’s population is infected with one form of intestinal parasites. Amoebiasis and giardiasis are among the leading intestinal protozoan infections that affected mankind. However, literature that shows the magnitude of the problem among university students in Ethiopia is at scarce. Therefore, this study was aimed at assessing the prevalence of feco-oral transmitted protozoan infections and associated factors among sport festival participant universities in Ethiopia.

Methods

A cross-sectional study design was conducted among 483 randomly selected university sport festival participant students. A self-administered questionnaire was used to collect the data. Stool specimens were examined using direct wet mount and formol-ether concentration techniques. The data were entered into Epi Info version 6.04 and were analyzed using SPSS version 20.0 statistical software. Multivariable logistic regression analysis was done to control the possible confounders and an odds ratio with a 95% confidence interval at p < 0.05 was used to identify an association between variables.

Result

The overall prevalence of intestinal protozoan infections was 140(28.9%) with the predominantly higher prevalence of E. histolytica/E. dispar 95(19.7%). The female respondents were at lower risk of infections compared to their male counterparts (AOR = 0.48, 95% CI: 0.22, 0.97]. Participants with educated father (AOR = 0.62, 95% CI: 0.12, 0.86) and those who received pocket money of > 347 Ethiopian Birr (~ 14 USD) per month (AOR = 0.20, 95% CI: 0.12, 0.74) were at lower risk of infections. However, being married (AOR = 1.42, 95% CI: 1.10, 2.23), rural resident (AOR = 1.82, 95% CI: 1.21, 3.32) and university stay for two or more years (AOR = 2.21, 95%CI: 1.48, 3.87) were more likely to be infected with protozoan infections.

Conclusion

The prevalence of intestinal protozoan infection among students who attend higher educational institutions was very high. Infection prevention strategies should be undertaken at respective universities with special focus to senior students and students from the rural area.

Electronic supplementary material

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Prevalence of Intestinal Parasitic Infections and Associated Factors Among Food Handlers in Wolaita Sodo University Students Caterings, Wolaita Sodo, Southern Ethiopia: A Cross-Sectional Study

Background: Intestinal Parasitic Infections (IPIs) are among the most prevalent diseases in the world, particularly in developing countries with low socio-economic and poor living conditions. From the estimated one third global population infected by intestinal parasitic infections; the majority lives in tropical and sub-tropical parts of the world. These diseases are highly prevalent in Ethiopia. However, its magnitude in the context of Wolaita Sodo University, where a large number of students reside in a campus is not studied. Therefore, the objective of this study was to assess the prevalence and factors associated with intestinal parasitic infections among food handlers in students' caterings of Wolaita Sodo University, Southern Ethiopia.

Methods: Institutional based cross sectional study was conducted among food handlers working in Wolaita Sodo University students' caterings' from January 10 to February 10, 2016. The study was undertaken among 233 food handlers by using simple random sampling technique. Data were collected using structured and pretested questionnaire; observation of food handlers while working and microbiological laboratory investigations. Bivariate and multivariate analyses were used to assess the association between covariate and the outcome variables. Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was considered to ascertain the significance of the association.

Results: The mean age of the study participants was 27.2 (±6.4 SD). The overall prevalence of intestinal parasitic infections was 23.6%, with 95% CI of 18.2% to 29.1% of which 12.4% was due to amoeba cyst. Untrimmed fingernail with AOR (95% CI) 2.06 (1.06, 4.00) and regular hand washing habit without soap before food handling with AOR (95% CI) 2.68 (1.25, 5.73) were found to be significantly associated with intestinal parasitic infections.

Conclusions: The prevalence of intestinal parasitic infections was high among Wolaita Sodo University food handlers. Untrimmed fingernail and hand washing habit without soap before food handling were found to increase odds of intestinal parasitic infections. The university may need to consider interventions recommended accordingly.

A cross-sectional study of enteric fever among febrile patients at Ambo hospital: prevalence, risk factors, comparison of Widal test and stool culture and antimicrobials susceptibility pattern of isolates

Background

Enteric fever is one of the common infectious diseases of humans. The objectives of this study were to:1) estimate the prevalence of enteric fever among febrile patients visiting Ambo hospital; 2) comparison of Widal test and stool culture;3) evaluation of the antimicrobial susceptibility of isolates; and 4) assess potential risk factors to acquire enteric fever infection.

Methods

Blood and stool samples were collected from 372 febrile patients with symptoms clinically similar to enteric fever. Widal test was used for testing sera while stool culturing and bacterial identification was done using WHO standard methods. Susceptibility testing was done using Kirby-Bauer disc diffusion method. Chi-Square test and Logistic Regression analysis were used to analyze the data.

Results

The apparent and true prevalence of enteric fever were 56.2% (95% confidence interval [CI]: 50.97–61.29%) and 57.52% (95% CI: 52.3–62.6%) respectively, while, the culture prevalence was 2.7% (95% CI: 1.30–4.89%). Isolation rates of S. Typhi and S. Paratyphi were 0.8% (95% CI: 0.17–2.34%) and 1.9% (95% CI: 0.76–3.84%) respectively. The isolates showed 100% resistance to amoxicillin, bacitracin, erythromycin, 80%resistance to cefotaxime and streptomycin and 20% for chloramphenicol. The sensitivity, specificity, positive and negative predictive values of Widal test was 80.0, 44.5, 3.8 and 98.8% respectively. Multivariable logistic regression analysis revealed that age (adjusted odds ratio [aOR] = 2.45; 95% CI: 1.38–4.37; P = 0.002), religion (aOR = 15.57, 95% CI: 3.01–80.64; P = 0.001), level of education (aOR = 2.60, 95% CI: 1.27–5.28; P = 0.009), source of water (aOR = 2.20, 95% CI: 1.21–3.98; P = 0.009), raw milk (aOR =2.19, 95% CI:1.16–4.16; P = 0.016) and raw meat consumption (aOR = 1.80, 95% CI: 1.07–3.01; P = 0.026) are the predictors of enteric fever seropositivity.

Conclusions

Patients were wrongly diagnosed and treated for enteric fever by Widal test. Therefore, rapid tests with better sensitivity and specificity are needed for the diagnosis of enteric fever. Provision of safe water and health education are vital to bring behavioral change towards raw food consumption.

Electronic supplementary material

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Prevalence and associated risk factors of intestinal parasitic infections among asymptomatic food handlers in Wollo University student's cafeteria, Northeastern Ethiopia

Objective

Intestinal parasitic infections (IPIs) are among the major public health and socioeconomic problems in developing countries like Ethiopia. Food-handlers that directly deal with production and distribution of foods between societies are one of the most important sources to transmit parasitic infections to humans. The aim of this study was to assess the prevalence and associated risk factors of intestinal parasites among asymptomatic food-handlers working in students’ cafeteria of Wollo University, Northeastern Ethiopia.

Result

A cross-sectional study was conducted among 200 asymptomatic food handlers at Wollo University from January 1 to February 20, 2018. Among the total participants 30 (15%) were infected with at least one intestinal parasites. The dominant parasite was E. histolytica (5.5%) followed by A. lumbricoides (4%) and then G. lamblia (3%). Finger nail trimming (p = 0.002, AOR: 4.35, 95% CI 1.71–11.04), medical checkup (p = 0.012, AOR: 4.01, 95% CI 1.37–12.25) and residence (p = 0.014, AOR: 3.16, 95% CI 1.26–7.95) were independent predictors of intestinal parasitic infection among the food handlers.

Epidemiology of Strongyloides stercoralis infection in Bolivian patients at high risk of complications

Background

Strongyloidiasis can be fatal in immunocompromised patients, but few epidemiological studies investigated the burden of this neglected tropical disease among these populations, particularly in low- and middle-income countries such as Bolivia. This study aimed to fill in this gap by estimating prevalence rate and risk factors associated with strongyloidiasis among patients at high risk of complications

Methods

A cross-sectional study was carried out in Santa Cruz (elevation 400 meters, tropical climate) and Cochabamba (elevation 2,500 meters, temperate climate), among patients with cancer, HIV infection and rheumatic or hematologic disease, using four coproparasitological techniques and one serological (ELISA) test.

Results

In total, 1,151 patients participated in this study, including individuals who were HIV-positive (30%) or with rheumatic (29%), oncologic (32%) or hematologic (9%) diseases. The serological and coproparasitological prevalence was 23.0% (95% confidence interval [CI], 20.7–25.5; n = 265/1151) and 7.6% (95% CI, 6.2–9.3; n = 88/1151), respectively, with an estimated actual prevalence of 20.2% (95% CI, 17.9–22.5). Positive serology and positive coproparasitology were associated with younger age and lower education levels. There was no significant difference in prevalence between Cochabamba and Santa Cruz as defined by coproparasitology (6.4% vs. 8.9%; p = 0.11) or serology (24.0% vs. 22.0%; p = 0.4). Among 64 patients in Cochabamba who had never travelled to the tropical lowlands, 5 (7.8%) had a positive coproparasitology.

Conclusions

Strongyloidiasis is widely prevalent in Bolivia among vulnerable patients at increased risk of life-threatening complications. Transmission of the parasite occurs both in tropical lowlands and temperate elevation (≥ 2,500 m). Control strategies to prevent transmission and complications of this serious parasitic disease should be urgently reinforced.

Strongyloidiasis is an understudied chronic intestinal infection and one of the most overlooked of the neglected tropical diseases, particularly in countries such as Bolivia. The strongyloidiasis usually remains paucisymptomatic for decades in immunocompetent persons, but may lead to severe conditions with high mortality rates in immunocompromised individuals. We carried out a study to explore the epidemiology of strongyloidiasis among Bolivian patients with cancer, HIV infection, and rheumatic or hematologic diseases. Our study highlighted that strongyloidiasis was widely prevalent in tropical and inter-Andean temperate areas of Bolivia among patients at high risk of life-threatening complications. One in five participants was infected. We showed that strongyloidiasis was highly prevalent in both tropical and temperate regions. Improved access to adequate diagnosis, treatment, and preventive measures are therefore urgently required in Bolivia, and most likely elsewhere in the region. Treatment of uncomplicated strongyloidiasis is simple, highly effective, and potentially life-saving.

Food handling practice and associated factors among food handlers in public food establishments, Northwest Ethiopia

OBJECTIVE

The objective of this study was to assess food handling practice and associated factors among food handlers in public food establishments, Northwest Ethiopia.

RESULTS

In this study a total of 416 food handlers were participated with a response rate of 416 (98.6%). Proportion of good food handling practice was 167 (40.1%) [95% CI (confidence interval): 35.10, 44.50]. Work experience [AOR (adjusted odds ratio):1.95, 95% CI 1.11, 3.45], good attitude (AOR = 1.97, 95% CI = 1.04, 3.72), secondary school education level (AOR 2.91, CI 1.20, 7.01), diploma and above education level (AOR 4.33, 95% CI 1.41, 13.31), use of three compartment dish-washing system (AOR 2.47, CI 1.27, 4.80) and use of refrigerator (AOR 3.93, CI 1.79, 8.63) were factors statistically associated with good food handling practice. This study indicated that food handling practice was relatively poor. Work experience, good attitude, level of education, use of three compartment dishwashing systems and refrigerator were factors associated with food handling practice. Hence, structuring the kitchen with modern dish washing system and refrigerator would enhance good food handling practice.

Epidemiology of Taenia saginata taeniosis/cysticercosis: a systematic review of the distribution in southern and eastern Africa

Background

The beef tapeworm, Taenia saginata, causing cysticercosis in bovines and taeniosis in humans, is thought to have a global distribution. In eastern and southern Africa, cattle production plays a crucial role in the economy, but a clear overview of the prevalence of T. saginata in the region is still lacking. This review aims to summarize existing knowledge on T. saginata taeniosis and bovine cysticercosis distribution in eastern and southern Africa.

Methods

A systematic review was conducted, that gathered published and grey literature, including OIE reports, concerning T. saginata taeniosis and bovine cysticercosis in eastern and southern Africa published between January 1st, 1990 and December 31st, 2017.

Results

A total of 1232 records were initially retrieved, with 78 full text articles retained for inclusion in the database. Unspecified taeniosis cases were reported for Angola, Ethiopia, Kenya, Madagascar, Malawi, South Africa, Tanzania, Uganda and Zambia, whereas T. saginata taeniosis cases were found for Ethiopia, Kenya, South Africa, Tanzania, Zambia and Zimbabwe. The prevalence of taeniosis ranged between 0.2–8.1% based on microscopy, and between 0.12–19.7% based on coproAg-ELISA. In Ethiopia, the percentage of tapeworm self-reporting was high (45.0–64.2%), and a substantial number of anthelmintic treatments were reported to be sold in towns. The presence of bovine cysticercosis was reported in all 27 countries/territories included in the study, except for Rwanda and Somalia, Comoros, Madagascar, Mauritius, Mayotte, Seychelles and Socotra. The prevalence of cysticercosis ranged between 0.02–26.3% based on meat inspection, and between 6.1–34.9% based on Ag-ELISA.

Conclusions

Although T. saginata has been reported in the majority of countries/territories of the study area, T. saginata taeniosis/cysticercosis remains a largely ignored condition, probably due to the absence of symptoms in cattle, the lack of data on its economic impact, and the fact that human taeniosis is considered a minor health problem. However, the occurrence of bovine cysticercosis is a clear sign of inadequate sanitation, insufficient meat inspection, and culinary habits that may favour transmission. Measures to reduce transmission of T. saginata are therefore warranted and the infection should be properly monitored.

Electronic supplementary material

The online version of this article (10.1186/s13071-018-3163-3) contains supplementary material, which is available to authorized users.