Factors associated with food safety practices among food handlers: facility-based cross-sectional study

Determinants of food safety knowledge and practices among food handlers in Bangladesh: An institution-based cross-sectional study

The engagement of a large number of people in big-scale cooking raises the danger of food contamination due to incorrect handling, whether deliberate or unintentional. Contamination during large-scale production poses a serious hazard to consumer health and has significant financial implications for a nation. This study aimed to investigate the food safety knowledge and practices of institutional food handlers in Bangladesh, considering the growing concern surrounding this issue and the lack of available information on foodborne illnesses related to institutions. In addition, the study aimed to determine the factors influencing both knowledge and practices. A cross-sectional study was conducted from June to September 2022, involving 408 institutional food handlers. The sample size was determined using Cochran's formula, and data was collected through purposive sampling. The participants were interviewed in person and completed a pilot-tested questionnaire. A multiple linear regression analysis was conducted to determine the factors related to food safety knowledge and practices. The majority of participants were female (71.3%) and aged between 26 and 35 (mean age 34.53 ± 9.06 years). They were most knowledgeable about hand hygiene and food separation but lacked knowledge about foodborne pathogens and food storage. Thawing food at room temperature was the most inappropriate practice (86%). The mean scores for knowledge and practice were found to be 16.11 ± 2.76 on a 26-point scale (61%), and 9.59 ± 2.07 on a 15-point scale (64%), respectively. Rural food handlers, those with higher education, working more than 10 h per day, and being familiar with HACCP, had higher knowledge. Food handlers aged 18 to 25, with higher income, working in private institutions, having food safety authority knowledge, actively engaging in food safety training, working more than 10 h per day, and having a positive health perception, had better food safety practices.The results of this study reinforce the notion that institutional food handlers would benefit from enhanced exposure to food safety interventions, active participation in training sessions, and strict adherence to food hygiene regulations in their food handling knowledge and practices.

Evaluation of Food Safety Knowledge and Attitudes Among Adults in the United Arab Emirates

Background Food is handled by many individuals in large food setups, therefore increasing the chance of contamination that leads to foodborne diseases (FBDs). This study was purposed to evaluate adults' understanding of food safety, FBDs, and hygiene practices across various demographic groups in the United Arab Emirates (UAE) and to explore the link between their knowledge of food safety and their corresponding attitudes. Methods A cross-sectional study was conducted with 402 adults using a validated, self-administered questionnaire available in both printed and online formats. The study was carried out at Gulf Medical University and Thumbay hospitals and clinics over six months, beginning in December 2022 to June 2023. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). The chi-squared test was employed to examine the association between variables, and significant associations were further analyzed through logistic regression. Results Out of the 402 participants, the population was predominantly female 275 (67.9%), and from Southeast Asia 222 (55.4%), with students comprising the largest occupational group 186 (47%). Only 106 (26.36%) had received food safety training, and a mere 187 (46.51%) demonstrated adequate knowledge. Awareness levels varied, with the highest for raw food safety (64.02%) and the lowest for canned foods (40.79%). Demographic analysis revealed significant associations: males exhibited more inadequate knowledge 79 (62.2%) than females 136 (49.4%), and students showed higher inadequacy 104 (55.9%) compared to healthcare workers 31 (35.6%). Positive attitudes towards food safety were prevalent 226 (56.2%), and positive attitudes were found in women 157 (57.1%), individuals above 30 years of age 110 (50.5%), individuals working in healthcare 140 (62%), and married individuals 117 (60.9%). With a strong correlation (p<0.001), women were 1.68 times more likely to possess adequate knowledge than men (95% CI: 1.09, 2.59), and healthcare workers were 2.33 times more likely than students (95% CI: 1.37, 3.95). Conclusion The study reveals a low level of knowledge about food safety among adults in the UAE. Therefore, emphasis should be placed on increasing awareness of these concepts to reduce the burden of FBDs on the healthcare system.

Knowledge, Attitude, and Practices on Food Safety among Food Handlers Working in Public Food Service Establishments in Lemi Kura Subcity, Addis Ababa, Ethiopia

Foodborne diseases, resulting from poor food handling and sanitation practices, are common public health problems globally. The primary contributing factors to potential foodborne disease outbreaks are often attributed to the poor perception and practices of food handlers regarding food safety. This study is aimed at assessing the knowledge, attitude, and practices of food handlers working in public food service establishments in Lemi Kura subcity, Addis Ababa, Ethiopia. A cross-sectional study was conducted from December 2022 to September 2023, involving 400 food handlers from 20 randomly selected public food service establishments. Data were collected using a structured interview-administered questionnaire and an observational checklist. The collected data were entered into Microsoft Excel and then transferred to SPSS version 20 for analysis. Descriptive statistics were employed to summarize the data, and Pearson's chi-square test was used to evaluate the association of sociodemographic factors with the knowledge, attitude, and practices of food handlers towards food safety. Of the 400 food handlers, 65.5% had good knowledge about food safety. All food handlers were knowledgeable that washing hand before handling food will reduce risk of poisoning, bacteria are the main cause of food poisoning, and temperature plays a big role in bacterial growth. This study also revealed that 65.3% of the food handlers had good attitude towards food safety and 55.3% of food handlers had good food handling practice. Based on the observation, 38.5% of food handlers had good food handling practice. Taking training, age, and work experience of food handlers have statistically significant (P < 0.05) association with good attitude towards food safety. Additionally, taking training, educational level, employment, and work experience of food handlers have statistically significant (P < 0.05) association with good practice towards food safety. However, there was no statistically significant association between all sociodemographic factors and knowledge about food safety. Good knowledge and attitude were also associated with good food handling practices of the respondents. Based on the observation, there was a statistically significant association between employment status and good food handling practice. In conclusion, the findings suggest the necessity for implementing formal educational and training programs aimed at positively influencing the knowledge and attitude of food handlers, subsequently improving their food handling practices.

The competence of street food vendors to provide nutritious and safe food to consumers: a cross-sectional survey among street food vendors in Northern Ghana

Increasingly most people have their meals outside their homes and are vulnerable to illnesses caused by unsafe foods. Unsafe food preparation and supply by vendors have made food safety a concern for public health. The present study evaluated the nutrition knowledge, attitude and food safety and hygienic practices of street food vendors (SFVs) in Northern Ghana. An analytical cross-sectional study design was conducted among 424 SFVs, and the data were collected using questionnaires and observation. The mean ± sd nutrition knowledge score of the SFVs was 7⋅08 ± 1⋅75 in which the majority of the participants (68⋅6 %) knew foods that help fight diseases and build immunity. The mean ± sd food safety and hygienic practice score was 7⋅61 ± 2⋅66 with more than half of the participants reportedly not using hand gloves while preparing and serving food. Factors that were associated with food safety and hygienic practices of the SFVs were level of education (β = -0⋅36, P < 0⋅001), number of hours worked (β = 0⋅15, P = 0⋅002), food hygiene and safety knowledge (β = 0⋅21, P = 0⋅002), having a business certificate (β = -0⋅15, P = 0⋅004) and having medical check-up (β = 0⋅11, P = 0⋅029). The food safety and hygienic practices of the SFVs may constitute a food safety risk to consumers. Improving food safety and hygiene knowledge may be important but regular monitoring and check-up by the FDA could result in SFVs following the required food safety and hygienic practices.

Food safety knowledge, attitude, and practice among male and female food handlers: Evidence from fruit and vegetable producers in Ethiopia

Studies on the level of knowledge, attitude and handling practice towards food safety would help to determine the associated factors of knowledge, attitude and practice towards food safety; however, these studies did not explicitly address food safety concerns related to fruit and vegetables in Ethiopia. Men and women could have different levels of knowledge, attitude, and handling practice; however, these gendered effects were not addressed in previous studies. Using data collected in 2021 from 311 farm households in Ethiopia, this study aimed to analyze the level of knowledge, attitude, and handling practice of fruit and vegetable and associated factors among male and female food handlers. Data was analyzed using descriptive statistics, spearman's correlation, and econometric models (logit, multinomial logit and ordered probit). Education has a positive significant effect on knowledge, attitude and handling practices of fruit and vegetable handlers. However, the effect was higher in the females. No correlation could be obtained between knowledge and practices for the total respondents. However, knowledge had a positive but weak significant association with practices in the female group. We found a significant positive correlation between knowledge and attitude. These findings indicated that food safety knowledge of fruit and vegetable handlers will influence their attitude and a positive attitude would influence the practice in safe handling of fruit and vegetables. It therefore may require more targeted campaigns (i.e. from awareness creation to behavior change) to increase the ability of the community members to adopt best practices while reducing the barriers associated with consuming unhealthy diets.

Food Safety Practice and Associated Factors of Food Handlers Working in Food Industries in Bahir Dar City, Amhara Regional State, Northwest Ethiopia, 2021

BACKGROUND

Food safety has emerged as one of the 10 threats to global health. Ethiopia is among the developing countries with many food industries in recent times. Poor food handling procedures, a lack of basic infrastructure, lack of potable water, lack of financial resources to invest in safer equipment, and lack of training for food handlers have all been reported.

OBJECTIVES

To assess food safety practices and associated factors among food handlers working in food industries in Bahir Dar city administrations.

METHODS

A cross-sectional study was conducted from January to February 2021 among 422 food handlers working in food industries in Bahir Dar city, Ethiopia. A random sampling technique was used to select food industries and study participants. The sample size was proportionately allocated to the selected food industries. Data were collected through face-to-face interviews and observation methods using interviewer-administered questionnaires and an observational checklist respectively. Data was entered into Epi-data v 3.1 and exported to SPSS v 23 for analysis. Bi-variable binary logistic regression was carried out to identify candidate variables at p-value <.2 and was entered into the final multivariable binary logistic regression model to control the effect of confounding. Variables with p-values of less than .05 were declared as statistically significant and an odds ratio of 95% CI was used to measure the strength of the association.

RESULT

Food safety practice among food handlers working in food industries was 47.6% (95% CI: 42.8, 52.5). Sex [AOR: 2.92 (CI: 1.77, 4.82)], monthly salary [AOR: 2.02 (CI: 1.18, 3.44)], health supervision [AOR: 3.43 (CI: 1.97, 5.97)], working unit [AOR: 2.44, (CI: 1.45, 4.13], food safety training [AOR: 6.16 (2.97, 12.77)], attitude [AOR: 3.55 (CI: 1.14, 11.05)] were factors significantly associated with food safety practice.

CONCLUSION

Food safety practice among food handlers was low. Sex, working unit, monthly income, regulatory supervision, food safety training, and attitude toward food safety were factors associated with poor food safety practices. In-service training on good hygiene practices, good manufacturing practices, hazard analysis, critical control point, food safety management systems, and supportive supervision should be strengthened.

Knowledge, attitude and practice of tomato retailers towards hygiene and food safety in Harar and Dire Dawa, Ethiopia

In this study, we assessed knowledge, attitude, and practices (KAP) related to tomato hygiene and food safety, among tomato vendors in the Ethiopian cities of Harar and Dire Dawa. From a total of 1498 tomato retail market vendors identified in the two cities through vendor mapping exercises, 151 outlets were randomly selected for a cross-sectional KAP survey on tomato handling, marketing, loss due to damage, safety, and hygienic practice. Tomato vendors claimed that they knew about food safety and hygiene, and risks associated with raw tomatoes. We found considerable variation in food safety knowledge, barriers, and practices during handling and marketing. The major concern of tomato traders in terms of food safety for vegetables was contamination with dirt. Around 17% of street vendors did not know about the importance of water quality and cleanliness for food safety. About 20% of tomato traders washed tomatoes after they purchased them and 43% and 14% of respondents who practiced tomato washing revealed that they cannot get the quantity and quality of water needed, respectively. Tomatoes were displayed in direct sunlight in about 85% of stalls. About 37% of vendors said rodents were present at night and could contact surfaces tomatoes are displayed on. For about 40% of outlets one or more flies were seen to be present on a third to two-thirds of their tomatoes. Overall, 40% of respondents reported they do not have adequate toilet facilities and 20% of those that use a toilet do not have water for washing hands after. The study identified areas that should be targeted by interventions aiming to improve food safety in this setting, however, without improvements in basic infrastructure to provide the pre-requisites for food safety the impact of small-scale food safety interventions may be limited.

Determinants of safe food handling practice among food handlers in food establishments, Yeka sub city, Addis Ababa, Ethiopia

Background

Poor food handling practice is a key cause of foodborne diseases notably in developing countries like Ethiopia. This study aimed to assess food safety knowledge, attitude and practice of food handlers, establishments' status and determinants of safe food handling practice.

Methods

The study utilized institution based cross-sectional study among food handlers working in Cafeterias, Restaurants and Hotels in Yeka sub city, Addis Ababa. A total of 284 food handlers: 69 from Cafeterias, 89 from Restaurants and 126 from non-stared Hotels were enrolled using stratified random sampling technique. Data were collected in observational checklist and through structured-questionnaire via face to face interview. A binary and multivariate logistic regression was used and adjusted for cofounders. A P-value of less than 0.05 was considered statistically significant.

Result

The present study has indicated 42.6% of food handlers had good food handling practice. Food handling practice in the establishments were significantly associated with sex, monthly income, availability of functional pipe water supply, availability of soap and/or detergents and presence of insects or rodents.

Conclusion

Food handlers in the study area were executing in a poor food handling practice, as most of them were not knowledgeable as needed. In fact, revising the salary of food handlers based on their work load could be valid, as there is existing worldwide economic inflation. Likewise enhancing pipe water availability in the food premises and dispatching sufficient soaps and detergents coupled with eradicating ubiquitous insects and rodents are key.

Food Hygiene Practices and Associated Factors Among Street Food Vendors in Urban Areas of Gedeo Zone, Southern Ethiopia

Background

Street food is expanding all around Ethiopia. Street vendors have become commonplace near schools, hospitals and bus stations. Because street vended food is sold in unsanitary surroundings near streets, it can be contaminated with variety of pathogens, exposing consumers to foodborne illnesses. There haven't been enough studies on Ethiopian street food, and little is known about how hygienic these foods are. The local authorities don't even have a regulatory system to ensure food safety for street food vendors. Thus, this study aimed to assess food hygiene practices among street food vendors and associated factors.

Methods

Community-based cross-sectional analytical study design was conducted from June, 2021 to July, 2021 including 402 respondents. Structured questionnaire and observational checklists were used for assessing food hygiene practices. Data were analyzed using SPSS statistics (version 25.0). Binary logistic regression analyses were used to check association of covariates with food hygiene practices. Adjusted odds ratio, and P-value less than 0.05 at 95% confidence interval were used to report significant association.

Results

Out of 402, 390 individuals responded. About 123 (31.5%) (95% CI: 27.2-36.4) of vendors had good food hygiene practices. Being female (AOR = 0.15; 95% CI: 0.09-0.27), age (19-25 years (AOR = 0.29; 95% CI: 0.11-0.81) and 26 to 35 years (AOR = 0.24; 95% CI: 0.08-0.74), marital status (being married (AOR = 0.52; 95% CI: 0.29-0.93), educational status (college and above (AOR = 3.42; 95% CI: 1.35-8.62), monthly income (1001-2000 Ethiopian Birr (AOR = 0.36; 95% CI: 0.19-0.68), being inspected (AOR = 13.15; 95% CI: 2.76-62.66) and lack of water at vending site (AOR = 0.40; 95% CI: 0.17-0.97) were factors significantly associated with food hygiene practices of street vendors.

Conclusion

Few street food vendors who adhered to good food hygiene were present. Significant variables of food hygiene behaviors included gender, age, marital status, education level, monthly income, inspection frequency, and the availability of water at vending sites. The vendors' food hygiene practices needed to be improved, which necessitated continual assistance, frequent inspections, and public awareness campaign.

Food safety practice and its associated factors among food handlers in food establishments of Mettu and Bedelle towns, Southwest Ethiopia, 2022

BACKGROUND

Food safety and hygiene are currently a global health concern, especially in unindustrialized countries, as a result of increasing food-borne diseases (FBDs) and accompanying deaths. It has continued to be a critical problem for people, food companies, and food control officials in developed and developing nations.

OBJECTIVE

The objective of the study was to assess food safety practices and associated factors among food handlers in food establishments in Mettu and Bedelle towns, south-west Ethiopia, 2022.

METHODS

A community-based cross-sectional study was conducted from February to March 2022, among 450 randomly selected food handlers working in food and drink establishments in Mettu and Bedelle towns, Southwest Ethiopia. Data was collected using an interviewer-administered structured questionnaire. The data was coded and entered into Epi Data version 3.1 before being exported to SPSS version 20 for analysis. Both bivariate and multivariable logistic regression models were fitted. An adjusted odds ratio and a 95% confidence level were estimated to assess the significance of associations. A p-value of < 0.05 was considered sufficient to declare the statistical significance of variables in the final model.

RESULT

A total of 450 food handlers participated in the study, making the response rate 99.3%. About 202 (44.9%) of respondents had poor practices in food safety. Lack of supervision (AOR = 6.2, 95% CI: 3.37, 11.39), absence of regular medical checkups (AOR = 1.98; 95% CI: 1.14, 3.43), lack of knowledge of food safety practices (AOR =2.32; 95% CI: 1.38, 3.89), availability of water storage equipment (AOR =0.37; CI: 0.21, 0.64), and unavailability of a refrigerator (AOR =0.24; 95% CI: 0.12) were factors significantly associated with food safety practices.

CONCLUSION

The level of poor food safety practices was remarkably high. Knowledge of food safety, medical checkups, service year as food handler, availability of water storage equipment, availability of refrigerator, and sanitary supervision were all significantly associated with food safety practice. Hence, great efforts are needed to improve food safety practices, and awareness should be created for food handlers on food safety.

Improper food handling and its associated characteristic factors among domestic food handlers in rural areas of Anhui Province in China

Improper domestic food handling in rural areas of China is an important public health issue leading to foodborne illness. However, the underlying factors responsible for poor domestic food hygiene practices have not been comprehensively studied. Here, a cross-sectional study was conducted in Anhui Province, China between 2015 - 2016, using a questionnaire to collect data from 819 respondents, selected using multistage cluster random sampling techniques. Multivariate logistic regression analysis was then used to assess the demographic factors associated with improper food handling. Results showed that 525 (64.1%) of respondents used improper food handling techniques. The factors associated with improper food handling included gender, age, education, income, and occupation. Males (vs. females), adults aged ≥ 50 years (vs. those aged 18 - 30 years), individuals with primary school education or lower (vs. individuals with a bachelor’s degree or higher), individuals with annual incomes of < 4,387 USD (vs. income ≥ 13,161 USD), and workers (vs. other occupation groups) were more likely to report inappropriate food handling practices in rural areas. The results obtained from the present work may provide the basis for training in domestic food safety hygiene/handling practices in rural areas of China in order to reduce the incidence of foodborne illnesses.

Knowledge of Food Safety and Handling Practices Among Food Handlers of Student Cafeteria at Kotebe Metropolitan University, Addis Ababa, Ethiopia

INTRODUCTION

Food-borne disease is a major health problem especially in low-income countries like Ethiopia. This study aimed to assess the knowledge and practice of food handlers at student cafeteria of Kotebe Metropolitan University.

METHODS

A cross-sectional study design was conducted among 68 food handlers in student cafeteria of Kotebe Metropolitan University from May 30, 2018 to October 30, 2019. A structured questionnaire was used via face-to-face interviews to assess food handler's knowledge of food safety and practices food safety. Data were analyzed using Statistical Package for the Social Sciences window version 20 and presented in the form of frequency tables, percentages, and graphs. The association was tested using Pearson's chi-square, where P-value (<.05) was considered statistically significant.

RESULTS

The result showed that food handlers had good knowledge of food safety and good practice of food safety measured by the passing score of 40 (57.94%) and 48 (70.6%), respectively. Almost all food handlers were aware of the crucial role of knowledge of food safety and food safety practices in the student cafeteria. Accordingly, results of this work revealed that 67 (98.5%), 60 (88.2%), 65 (95.6%), and 56 (82.4%) of the subjects had food safety knowledge, always wash vegetables and fruits, had hand washing facilities with a supply of hot water, soap, and hand drying towel, had a hair mask or cloth during food preparation, and wore safety cloth during food preparation, respectively.

CONCLUSION

The findings revealed significant relationship between food safety practices of food handlers and level of education, specifically regarding access to hand washing facilities, hand washing after a break and in the toilet, changing gloves between raw and ready-to-eat food, and drying and cleaning hands before handling food (P < .05). Additionally, Kotebe Metropolitan University should design food handling and safety guidelines and offer specific training for food handling workers.

Food safety knowledge and practice of abattoir and butcher shop workers: a health risk management perspective

BACKGROUND

Meat is rich in essential proteins and valuable nutrients for human health. Despite these benefits, it is a favorable medium for microbial growth and transmission to humans unless recommended safety procedures are followed. This research aimed to assess the level of knowledge and practice of the abattoir and butcher shop workers who were working in the meat value chain.

METHODS

The cross-sectional study design, using structured questionnaire interviews was used to assess the knowledge and practice of abattoir and butcher shop workers. A total of 226 randomly selected workers were participated in this study and bivariate logistic regression was used for data analysis.

RESULTS

Of 226 total participants, 46% were abattoir workers and 54% were butcher shop workers. Majority (88.9%) of the participants did not know about meat safety and 74.3% of the participants had insufficient practices. The cumulative knowledge of both abattoir and butcher shop workers was significantly associated (p = 0.001) with their knowledge of the presence of diseases causing agents in meat, the source of meat contamination, and the common critical points of meat contamination along the meat value chain. The cumulative practice of abattoir workers was significantly associated with their practices on daily meat transporting vehicle washing (p = 0.007), reducing meat contamination (p = 0.001), duration of animal fasting before slaughter (p = 0.039), cleaning of the animal body before slaughter (p = 0.002), cleaning material used in the abattoir (p = 0.003), disposal of abattoir waste (p = 0.002), and type of biosecurity measures used (p = 0.013). Similarly, the cumulative practice of butcher shop workers was associated (p = 0.001) with their practices of attracting customers, storing remaining meat from daily sales, and measures on contaminated food. Employment of the participants was significantly associated with both the cumulative knowledge (p = 0.007) and practice (p = 0.001) of the participants while the age of the participants was associated (p = 0.001) with only their cumulative practices.

CONCLUSIONS

In general, the participants' food safety knowledge and practice were unsatisfactory. As a result, the integrated food safety policy formulation in a One Health framework, and collaborative awareness creation among different food safety stakeholders were recommended.

Food Safety Practice and Its Associated Factors among Meat Handlers in North Shewa Zone, Oromia, Ethiopia

Background

Foodborne illness is one of the major public health problems globally. The majority of foodborne diseases arise from foods of animal origin. Hence, this study was proposed to evaluate meat handling practices and associated factors working in butcher shops in North Shewa Zone.

Methods

Data were collected through face-to-face interviews using a pretested structured questionnaire. Data were entered into a computer and analyzed using SPSS version 26. Binary logistic regression was used to identify factors associated with meat handling practice.

Result

The majority, 128 (57.1%), of meat handlers smoke in workplaces, and 20 (8.9%) of meat handlers handled money while processing meat. 180 (80.4%) of meat handlers process/handle meat when they had cuts, wounds, bruises, or injuries on their hands. 12.1% and 15.6% of meat handlers took food safety training and medical checkups, respectively. 51.3% of meat handlers had good meat handling practices. Knowledge (adjusted odds ratio [AOR] 2.99, 95% confidence interval [CI] 1.73-5.15), attitude (AOR = 1.94, 95% CI: 1.12-3.37), experience (AOR = 4.27, 95% CI: 2.34-9.85), medical checkup (AOR = 3.87, 95% CI: 1.67-8.96), and educational status (AOR = 5.50, 95% CI: 1.05-28.75) were significantly associated with meat handling practices.

Conclusions

Food hygiene training before employment and awareness creation for meat handlers should be strengthened. Routine inspections by responsible authorities are also recommended. Future studies should focus on the enumeration of bacterial load from utensils and meat handlers.

JE, Tareq MA, Begum MR, Chowdhury MFT, Schack T. Assessment of Food Safety Knowledge, Attitudes and Practices of Food Service Staff in Bangladeshi Hospitals: A Cross-Sectional Study

Food safety knowledge, attitudes and practices among hospital food service staff are crucial in the prevention of foodborne disease outbreaks, as hospitalized patients are more vulnerable to potential hazards. This study, therefore, sought to assess the food safety knowledge, attitudes and practices of food service staff in Bangladeshi hospitals. A cross-sectional study was conducted among 191 food service staff from seven different hospitals in Dhaka and Chattogram from October 2021 to March 2022 using pretested questionnaires. Multiple linear regression was used to identify the factors associated with the food safety knowledge, attitudes and practices. The findings showed moderate knowledge but high levels of attitudes and practices of food safety among hospital food handlers. Food safety knowledge was significantly higher among males, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations. Moreover, participants from private hospitals and participants working in a hospital that had a food service supervisor and dietitian in charge of food service operations had more positive attitudes and better practices regarding food safety. Hospital management should consider these factors for enhancing food handlers’ knowledge and increase training and supervision on food safety practices to reduce foodborne diseases and outbreaks.

Food safety practice and associated factors in public food establishments of Ethiopia: A systematic review and meta-analysis

Background

In terms of global impact, foodborne infections have been likened to major infectious diseases such as HIV/AIDS, malaria, and tuberculosis, with 1 in 10 people becoming ill and 420,000 deaths per year. A large number of these incidents are caused by improperly handled food in foodservice establishments. Therefore, this systematic review and meta-analysis aims to estimate the proportion of food handlers in Ethiopian commercial food service establishments who have safe food handling practices and their associated factors.

Methods

Studies conducted before 02-05-2022 were explored in PubMed, Science Direct, Web of Science, Scopus, Embase, Google Scholar, ProQuest, and Ovid MEDLINE^®, as well as other sources. A total of fourteen studies were included in the final synthesis. Data were extracted using a standardized data extraction format prepared in Microsoft excel and the analysis was done using STATA 16 statistical software. The quality of included studies was assessed using the Joanna Briggs Institute’s Critical assessment checklist for prevalence studies. To evaluate publication bias, a funnel plot and Egger’s regression test were employed. The I² statistic was calculated to examine for study heterogeneity. To assess the pooled effect size, odds ratios, and 95% confidence intervals across studies, the DerSimonian and Laird random-effects model was used. Subgroup analysis was conducted by region and publication year. The influence of a single study on the whole estimate was determined via sensitivity analysis.

Results

Of 323 identified articles, 14 studies were eligible for analysis (n = 4849 participants). The pooled prevalence estimate of safe food handling practices among Ethiopian food handlers was 47.14% (95% CI: 39.01–55.26, I² = 97.23%). Foodservice training (OR, 3.89; 95% CI: 2.37–5.40), having on-site water storage facilities (OR, 4.65; 95% CI: 2.35–6.95), attitude (OR, 4.89; 95% CI: 1.39–8.29), hygiene and sanitary inspection certification (OR, 3.08; 95% CI: 1.62–4.45) were significantly associated with safe food handling practice among food handlers.

Conclusion

This review identified that improvements are needed in food handling training, government regulation, and infrastructure. Standard regulations for food service enterprises must be implemented on a local and national level. Though long-term food safety requires legislation and training, failure to address infrastructure challenges can harm public health efforts. Access to safe drinking water and the presence of sanitary waste management systems should all be part of the basic infrastructure for ensuring the safety of food in food businesses.

Food hygiene practices and determinants among food handlers in Ethiopia: a systematic review and meta-analysis

Background

Food-borne diseases are a major public health concern worldwide, particularly in low and middle-income countries (LMICs), such as Ethiopia. Poor food hygiene practices primarily exacerbate food-borne illness transmission. Prior studies on the food hygiene practices among food handlers in Ethiopia were inconsistent. Therefore, this meta-analysis and systematic review aimed to estimate the pooled proportion of good food hygiene practices and identify the determinants in Ethiopia.

Methods

The preferred reporting items for systematic review and meta-analysis (PRISMA) instruments were used, and a systematic search was performed in the PubMed/MEDLINE, POPLINE, HINARI, Science Direct, Cochrane Library databases, and Google Scholar were systematically last searched on the 24th February 2022 for relevant articles. Only the observational studies that reported the proportion of good food hygiene practices and their associated factors among food handlers were included. The quality of the included studies was assessed by two independent authors. Articles with unclear methodologies and did not report the overall proportions of good food hygiene practice were excluded. The effect estimates for pooled proportion and pooled odds ratio (POR) along with a 95% confidence interval (CI) were determined conducting using DerSimonian–Laird's random effect model.

Results

Among 817 retrieved studies, 23 eligible articles with a total sample size of 7153 study participants were included in the meta-analysis. The pooled proportion of good food hygiene practices among food handlers was 50.5% [95% CI: (41.6, 59.4%]; I² = 98.7%, p value = 0.001]. Food handlers with formal education (POR = 4.60, 95% CI: 3.05, 6.93), good knowledge (POR = 1.98, 95% CI: 1.26, 3.11), training (POR = 3.52, 95% CI: 2.35, 5.28), and a positive attitude (POR = 3.41, 95% CI: 2.52, 4.61) about food hygiene components, as well as regular medical checkups (POR = 6.75, 95% CI: 4.49) were significantly associated with good food hygiene practice.

Conclusions

Only half of Ethiopia's food handlers had good food hygiene practice.

Implication of the study

The key elements of effective food hygiene practice that will aid in the development of feasible interventions to increase food handler compliance with food hygiene components have been identified.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41182-022-00423-6.

Food handling practice and associated factors among food handlers in public food establishments of Ethiopia: a systematic review and meta-analysis

OBJECTIVES

Food handlers are individuals who are involved in food preparation, storage or service of food in a food facility. Unless they keep their personal hygiene, they are highly responsible for contaminating food or transmitting microbes to consumers. Thus, the main aim of this review was to pool the level of good food handling practice among food handlers working in public food establishments in Ethiopia.

DESIGN

A systematic review and meta-analysis using the Joanna Briggs Institute (JBI) Critical Appraisal tool.

DATA SOURCES

PubMed, Google Scholar and Advanced Google were searched up to the end of February 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Publication status, publication language, type of study participants and the type of article were used to screen the article.

DATA EXTRACTION AND STUDY QUALITY ASSESSMENT

All reviewers collected data independently and merged them together. A tool called the JBI Meta-Analysis of Statistics Assessment and Review Instrument was used to assess the quality of each research article. The assessment was performed by two reviewers.

RESULT

A total of 16 research articles were included in the review. The pooled level of good food handling practice was 50.72% with 95% CI (43.84% to 57.6%). Training (adjusted OR (AOR)=3.4, 95% CI (2.33 to 4.95)), attitude (AOR=3.62, 95% CI (2.23 to 5.85)) and medical check-up (AOR=5.12, 95% CI (2.93 to 8.95)) were identified as factors affecting good food handling practice with 95% CI at p<0.05.

CONCLUSION

The level of good food handling practice among food handlers working in public food establishments of Ethiopia was very low compared with literature, and variables such as food handler training, attitude towards good food handling practice and the existence of regular medical check-ups were factors affecting good food handling practice. Provision of training that could change the attitude and regular medical check-ups for food handlers has to be in place.

Self-Reported Food Safety Practices and Associated Factors Among Health Extension Model and Non-Model Households in Northeastern Ethiopia: A Comparative Cross-Sectional Study

Purpose

Eating contaminated food continues to cause numerous food-borne diseases globally. Understanding the causes of poor food safety practices is key to preventing food-borne diseases. Therefore, this study aimed to assess the prevalence of food safety practices and associated factors among health extension model and non-model households in Kombolcha, Ethiopia.

Methods

A comparative cross-sectional study was conducted among 327 model households and 329 non-model households in Kombolcha. Four kebeles were selected randomly from a total of 12 kebeles, followed by a systematic random sampling method to select a total of 656 households. The data were collected through face-to-face interviews with household heads and observations from April 15 to May 15, 2021. Data were entered into EpiData version 3.1 and analyzed using SPSS version 25.0. Determinants of food safety practices were determined by using multivariable logistic regression model at a p-value <0.05.

Results

The overall prevalence of food safety practices was 44.7% (95% CI: 40.5-48.4%), of which 57.8% (95% CI: 53.0-63.1%) were model and 31.6% (95% CI: 26.5-36.7%) were non-model households, with significant variation among household types. Being a model household (AOR=2.99; 95% CI: 1.98-4.52), having a female household head (AOR=3.13; 95% CI: 2.13-4.59), proper solid waste management (AOR=2.32; 95% CI: 1.54-3.48), good knowledge of food safety (AOR=2.05; 95% CI: 1.43-3.03), and good attitude (AOR=1.74; 95% CI: 1.22, 2.49) were significant predictors of good food safety practices.

Conclusion

The prevalence of good food safety practices was not satisfactory. Being a model household, having a female household head, proper solid waste management, good knowledge, and good attitude were significantly associated with good food safety practices. Therefore, the identified modifiable factors are potential areas of intervention to enhance good food safety practices.

Developing a Catering Quality Scale for University Canteens in China: From the Perspective of Food Safety

This study aimed to create a catering quality scale for university canteens in China. It is based on a questionnaire survey, with a total of 1302 distributed and 844 valid retrieved questionnaires, yielding a 64.8% recovery rate. Catering safety management, employee hygiene management, catering service, food quality, environmental atmosphere, and corporate social responsibility are the six topics primarily covered. In the first step of the scale, the dimensions were developed through EFA. Catering safety management includes kitchen safety, storage safety, and food safety. Employee hygiene management has two dimensions: Employee hygiene knowledge and employee management. Catering service includes service consciousness and a focus on consumers. Environmental atmosphere includes place management and place design. Further, corporate social responsibility encompasses social responsibility and taking care of employees. The second step of the scale involved conducting a CFA, which found a good overall fit of the scale. The results indicated good discriminant validity, convergent validity, and reliability. Moreover, the model comparison showed that the two-level, six-factor model was significantly better than other models.

Hygienic Food Handling Practices and Associated Factors Among Food Handlers in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

The food handling practices of food handlers can have a significant impact on the hygienic status of the food. The aim of this study was to determine the prevalence and factors associated with hygienic food handling practices among food handlers in Ethiopia.

METHODS

PubMed, Science Direct, Google Scholar, and the Cochrane Library databases were used to find articles. Only cross-sectional studies that met the criteria for inclusion were considered. STATA version 16 statistical software was used to perform the meta-analysis. The study's heterogeneity was determined using Cochrane Q test statistics and the I ² test. A random effect model was used to calculate the pooled prevalence of hygienic food handling practices.

RESULTS

To estimate the pooled prevalence of hygienic food handling practices in Ethiopia, 9 out of 33 reviewed studies were included. The prevalence of hygienic food handling practices was found to be 48.36% (95% CI: 39.74-56.99) in this study. Factors associated with hygienic food handling practices included; lack of food safety training (OR = 5.38; 95% CI: 1.71, 16.89), negative attitude (OR = 3.28; 95% CI: 1.50, 7.13), lack of access to handwashing facilities (OR = 4.84; 95% CI: 1.72, 13.65), lack of regular medical checkup (OR = 5.37; 95% CI: 3.13, 9.23), and lack of secondary education (OR = 2.51; 95% CI: 1.46, 4.32) among food handlers.

CONCLUSION

In this study, the prevalence of hygienic food handling practices among Ethiopian food handlers was significantly low. Unhygienic food handling practices were attributed to a lack of food safety training, regular medical checkups, handwashing facilities, an unfavorable attitude toward food hygiene practices, and a lack of formal education. As a result, food handlers should receive ongoing food safety and hygiene training.

Food Safety Practices and Associated Factors among Food Handlers of Fiche Town, North Shewa Zone, Ethiopia

Background

Foodborne diseases remain a major public health problem globally, but the problem is severe in developing countries like Ethiopia. The objective of this study was to assess food safety practices and associated factors among food handlers of Fiche town.

Methods

A cross-sectional study was conducted among 422 food handlers working in food and drink establishments. The data were collected using a structured questionnaire and observational checklist. Data were entered and coded into SPSS for analysis. Multivariable logistic regression was used to identify the predictor variables associated with the practice of food handlers (p < 0.05).

Result

61.6% of food handlers knew the potential risk of contaminating food with dirty hands, and 70% washed hands with soap before working with food. 52.8% of food handlers covered the hair with restraints. 66.8% of food handlers used outer garments, and the majority of food handlers (71.1%) had a trimmed fingernail. Two hundred thirteen (50.5%) of food handlers had good food handling practices. Medical checkup (AOR = 3.16; 95% CI 1.89, 5.26), sanitary inspection (AOR = 1.76; 95% CI 1.16, 2.69), knowledge (AOR = 2.31; 95% CI 1.53, 3.48), service year (AOR = 3.11; 95% CI 1.53, 6.31), and educational status (AOR = 3.42, 95% CI 1.29, 9.04) were found to be significantly associated with food handling practices.

Conclusion

The food handlers should take various training concerning food hygiene and safety to enhance their knowledge and practice. Regular sanitary inspection of food and drink establishments is recommended.

Food safety knowledge, attitude, and hygiene practices of street-cooked food handlers in North Dayi District, Ghana

BACKGROUND

Food safety and hygiene are currently a global health apprehension especially in unindustrialized countries as a result of increasing food-borne diseases (FBDs) and accompanying deaths. This study aimed at assessing knowledge, attitude, and hygiene practices (KAP) of food safety among street-cooked food handlers (SCFHs) in North Dayi District, Ghana.

METHODS

This was a descriptive cross-sectional study conducted on 407 SCFHs in North Dayi District, Ghana. The World Health Organization's Five Keys to Safer Food for food handlers and a pretested structured questionnaire were adapted for data collection among stationary SCFHs along principal streets. Significant parameters such as educational status, average monthly income, registered SCFHs, and food safety training course were used in bivariate and multivariate logistic regression models to calculate the power of the relationships observed.

RESULTS

The majority 84.3% of SCFHs were female and 56.0% had not attended a food safety training course. This study showed that 67.3%, 58.2%, and 62.9% of SCFHs had good levels of KAP of food safety, respectively. About 87.2% showed a good attitude of separating uncooked and prepared meal before storage. Good knowledge of food safety was 2 times higher among registered SCFHs compared to unregistered [cOR=1.64, p=0.032]. SCFHs with secondary education were 4 times good at hygiene practices of food safety likened to no education [aOR=4.06, p=0.003]. Above GHc1500 average monthly income earners were 5 times good at hygiene practices of food safety compared to below GHc500 [aOR=4.89, p=0.006]. Registered SCFHs were 8 times good at hygiene practice of food safety compared to unregistered [aOR=7.50, p<0.001]. The odd for good hygiene practice of food safety was 6 times found among SCFHs who had training on food safety courses likened to those who had not [aOR=5.97, p<0.001].

CONCLUSIONS

Over half of the SCFHs had good levels of KAP of food safety. Registering as SCFH was significantly associated with good knowledge and hygiene practices of food safety. Therefore, our results may present an imperative foundation for design to increase food safety and hygiene practice in the district, region, and beyond.

Food Safety Knowledge, Handling Practices and Associated Factors Among Food Handlers Working in Food Establishments in Debre Markos Town, Northwest Ethiopia, 2020: Institution-Based Cross-Sectional Study

Purpose

Foodborne illness is a major public health problem worldwide. The supply of safe and healthy food is crucial to prevent foodborne illness. However, evidence regarding food safety knowledge and handling practice is limited in Ethiopia. Therefore, this study aimed to assess food safety knowledge, handling practice, and its associated factors among food handlers in Debre Markos Town, North West Ethiopia.

Patients and Methods

An institutional-based cross-sectional study was conducted on 408 randomly selected food handlers at Debre-Markos town. A structured questionnaire and an observational checklist were used to collect relevant data. The main outcome of interest was food safety and handling practice. Multivariable logistic regression analysis was used to identify the factors significantly associated with food safety knowledge and food handling practice. Data were analyzed using SPSS version 25.

Results

In this study, only 34.1% of food handlers had good food safety knowledge and nearly 54% of food handlers had good food handling practice. Level of education (AOR = 0.23 (0.14–0.57)), training on food safety (AOR = 5.13 (3.57–7.82)), and favorable attitudes towards food safety (AOR=2.54 (1.52–4.25)) were the factors associated with knowledge of food safety. Similarly, training (AOR=2.05, 95% CI=1.31–3.19), a good level of knowledge (AOR: 1.68, 95% CI: 1.40, 3.17), and work experience (AOR = 1.24, 95% CI: 1.10–2.81) were positively associated with good food handling practice.

Conclusion

In this study, the level of food safety knowledge and handling practices were relatively low. Therefore, the concerned bodies should work on the identified factors to improve food handlers’ knowledge of food safety and practice level. Continuous training for food handlers should be given.

Food safety practices of food handlers at home engaged in online food businesses during COVID-19 pandemic in the Philippines

This study was conducted to assess the self-reported and observed food safety practices (FSP) of food handlers, who deliver food products that are prepared and cooked at home during the COVID-19 pandemic in the Philippines. 751 participated in the online survey who were selected using criterion sampling. A questionnaire developed by the researcher was used to gather data with Cronbach Alpha of 0.91. t-test, ANOVA, and Fleiss kappa were performed to treat data. There were no significant differences between self-reported FSP in four dimensions and demographic characteristics, except for age, where a significant difference exists between the FSP of the four age groups along food preparation (F ​= ​4.530,ρ<0.01). The FSP in the four dimensions obtained a weighted x¯ and σ of 1.72 ​± ​0.69 which is interpreted as Sometimes Practiced. The food handlers at home inadequately and inappropriately practiced the protocols in keeping the food safe to eat. The observed reports showed that the food handlers at home do not meet food safety standards as indicated in the weighted x¯ and σ in the four dimensions 1.63 ± 0.11, with a description of Sometimes Practiced. Observed practices further show very poor adherence to guidelines. Test for inter-rater reliability yielded almost perfect agreement (κ ​= ​0.81, ρ<0.05). There exists a significant difference with the FSP in personal hygiene (t ​= ​0.964, ρ<0.05), cross-contamination prevention and sanitation (t ​= ​0.815, ρ<0.05), food preparation (t ​= ​0.753, ρ<0.05), and food delivery (t ​= ​0.794, ρ<0.05). Government and non-government agencies should work together towards educating the food handlers at home on effective ways to learn about food safety concepts so they could become advocates of safer food practices.

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Online food business is growing due to restrictions brought about by the pandemic.

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Self-reported FSP of food handlers reveal compliance to food safety standards.

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Food handlers violate food safety protocols based on expert observations.

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There is significant difference between the self-reported and the observed FSP.

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Food safety training involving food handlers in online businesses is imperative.

Food Safety Knowledge, Attitude, and Practice of College Students, Ethiopia, 2019: A Cross-Sectional Study

BACKGROUND

Since the dawn of human history, foodborne diseases have been a problem for all societies, and it is an increasing public health issue worldwide. The objective of this study is to examine knowledge, practice, and attitude in food safety among college students in the city Gondar, northwest Ethiopia.

METHODS

A cross-sectional study was conducted among 430 randomly selected college students in Gondar City, northwest Ethiopia, from October 8 to November 30, 2019. The data was gathered through a self-administered questionnaire. The collected data were checked for completeness, coded manually, and entered into Epi Info version 7, then exported to SPSS version 26 for more data checking, cleaning, and analysis. One-way ANOVA was done for examining sociodemographic variable association with KAP, and Pearson correlation analysis was conducted to measure the association among food safety knowledge, attitude, and practice scores. The p value < 0.05 was considered statistically significant for both tests.

RESULTS

The number of females was higher among the study participants (65.5%). The mean age of participates was 21.1 ± 9.14 (SD) years. The higher percentage (45.7%) of the participants were students in the second year. The overall scores of the food safety knowledge, attitude, and practices of the respondents were 35.7% (good), 38.0% (good), and 29.1% (positive), respectively. Participants with differences in gender, year of study, and food safety training had a substantial variation in overall food safety knowledge (p value < 0.05). The findings have clearly shown that knowledge of food safety does not directly affect the attitude towards food safety (p value > 0.05). On the other hand, overall food safety practice differed in terms of sex, year of schooling, and knowledge of food safety (p value < 0.05) among participants. Training and knowledge score had significant correlation among respondents (p value < 0.05).

CONCLUSION

This study revealed that the overall knowledge, practices, and attitude towards food safety among college students were very low. There was a significant association between knowledge and practice while food safety practices were independent with an attitude among the students. Such results indicated that there could be problems with foodborne diseases. Therefore, the findings of this study proposed that strength should be done to improve the existing food safety knowledge, practice, and attitude in college students in addition to their normal education.

An assessment of the food safety knowledge and attitudes of food handlers in hospitals

BACKGROUND

The possession of inadequate food safety knowledge (FSK) by food handlers poses a serious threat to food safety in service establishments. The aim of this research was to investigate factors that influenced the FSK and food safety attitudes (FSA) of employees involved in the preparation and/or the serving of food from nine hospitals in the Capricorn District Municipality (CDM) in Limpopo Province, South Africa.

METHOD

Up to 210 individuals (18-65 years) who were employed in these hospitals, and who were involved in the preparation and serving of food to patients were purposefully selected. Data collection was by means of an interview using a questionnaire design for this study. The FSK and FSA scores of hospital food handlers were obtained by adding the correct response to FSK or FSA questions.

RESULTS

Only 29% of the hospital food handlers have attended a food safety-training course. Many food handlers were not knowledgeable on the correct temperature for handling foods, and on the correct minimum internal cooking temperature for poultry, seafood and egg. Only the minority of food handlers knew that Salmonella is the main foodborne bacteria pathogen mostly associated with poultry products (47.1%) and that food borne bacteria will grow quickly in food at a temperature of 37 °C (38.1%). Hospital food handlers with higher academic qualifications do not possess more FSK than those with lower academic qualifications. 51% of the hospital food handlers possessed a Satisfactory FSK while 10% possessed a Good FSK and 39% possessed an Inadequate FSK.

CONCLUSION

More than 60% of the hospital food handlers possesses either Good FSK or Satisfactory FSK. Higher levels of education, experience in food handling and job position did not lead to better FSK outcome. All the hospital food handlers possess at least a Satisfactory FSA. There was a weak positive but significant correlation between the FSK and FSA of hospital food handlers. It is recommended all employees involved in food handlers be subjected to food safety training programmes on a regular basis irrespective of their academic, employment and training details.