Effect of Microbial Quality of Washing Water on Hand Hygiene Status of Food Handlers in Jimma Town: Implication for Food Hygiene and Safety

Microbiological assessment of ready-to-eat foods and drinking water sources as a potential vehicle of bacterial pathogens in northern India

Foodborne illnesses caused by the consumption of contaminated foods have frequent occurrences in developing countries. The incorporation of contaminated water in food processes, preparation, and serving is directly linked to several gastrointestinal infections. Keeping in view, this study was conducted to assess the microbial quality of both drinking water sources and commonly consumed fresh ready-to-eat (RTE) foods in the region. The drinking water samples from water sources and consumer points, as well as food samples from canteens, cafes, hotels, and restaurants, were collected for the microbiological analysis. Fifty-five percent (n = 286) of water samples were found to be positive for total coliforms with MPN counts ranging from 3 to 2600 (100 ml) -1. E. coli was detected in nearly 30% of the total water samples. Overall, 65% tap water samples were found unsatisfactory, followed by submersible (53%), filter (40%), and WTP (30%) sources. Furthermore, the examination of RTE foods (n = 80) found that 60% were of unsatisfactory microbial quality with high aerobic plate counts. The salads were the most contaminated category with highest mean APC 8.3 log CFU/g followed by pani puri, chats, and chutneys. Presence of coliforms and common enteropathogens was observed in both water and food samples. The detected isolates from the samples were identified as Enterobacter spp., Klebsiella spp., Pseudomonas aeruginosa, Salmonella spp., Shigella spp., and Staphylococcus spp. Based on these findings, microbiological quality was found compromised and this may pose hazard to public health. This exploratory study in the Punjab region also suggests that poor microbiological quality of water sources can be an important source of contamination for fresh uncooked RTE foods, thus transferring pathogens to the food chain. Therefore, only safe potable drinking water post-treatment should be used at all stages.

Prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia

Introduction

Bacterial pathogens continue to be a major cause of foodborne gastroenteritis in humans and remain a public health problem. Housemaids operating inside a kitchen could be the source of infection and may transmit disease-inflicting pathogens through contaminated hands.

Objective

This study aimed to assess the prevalence and antimicrobial susceptibility profile of bacteria isolated from the hands of housemaids in Jimma City, Ethiopia.

Methods

A laboratory-based cross-sectional study was employed among 234 housemaids. Hand swab samples from the dominant hand of the study participants were collected under sterile conditions following standard operating procedures. Then, in the laboratory, the swabs were inoculated aseptically using streak-plating methods on the growth media, such as mannitol salt agar [Staphylococcus aureus and coagulase-negative staphylococci], MacConkey agar [Klebsiella species and Proteus species], salmonella-shigella agar [Salmonella species and Shigella species], and eosin methylene blue agar [Escherichia coli (E. coli)]. In addition, a set of biochemical tests was applied to examine bacterial species. Data were double-entered into EpiData version 3.1 and then exported to the Statistical Package for Social Science (SPSS) version 26 for further analysis. Descriptive analyses were summarized using frequency and percentage.

Results

The proportion of housemaids' hands containing one or more positive bacterial isolates was 72% (95% CI: 66.2, 77.8). The dominant bacterial isolates were Staphylococcus aureus (31.6%), Escherichia coli (21.3%), Salmonella species (1.3%), Shigella species (6.7%), Klebsiella species (23.1%) and Proteus species (14.7%). Fingernail status (AOR =15.31, 95% CI: 10.372, 22.595) and the removal of a watch, ring, and bracelet during hand washing (AOR = 20.844, 95% CI: 2.190, 9.842) were significantly associated with the prevalence of bacterial isolation. Most Staphylococcus aureus isolates were susceptible to chloramphenicol (98.6%). Escherichia coli isolates were susceptible to tetracycline (75%), ceftriaxone (79.2%), chloramphenicol (87.5%), and ceftazidime (77.1%). Eighty percent of isolated Shigella species were susceptible to chloramphenicol and gentamicin respectively. In addition, Klebsiella and Proteus species exhibited high susceptibility to chloramphenicol. However, their isolates showed resistance against a number of the tested antimicrobials. Staphylococcus aureus isolates (28.2%) were resistance to tetracycline. Moreover, One-quarter of Escherichia coli isolates were resistance to tetracycline, ceftriaxone, chloramphenicol, and ceftazidime. Whereas 46.7% and 48.5% of isolated Shigella species and Proteus species were resistance to tetracycline and ceftriaxone.

Conclusion

The hands of housemaids are important potential sources of pathogenic bacteria that would result in the potential risk of foodborne diseases. Most bacteria isolates were resistant to tetracycline, ceftriaxone, and ceftazidime. Therefore, practicing good hand hygiene helps to prevent and control the spread of antimicrobial-resistant microbes.

Hand hygiene status and its associated factors among housemaids working in communal living residences in Jimma city, southwest Ethiopia

Objective

Hand hygiene is a milestone, cost-effective, and convenient strategy to prevent the transfer of pathogenic micro-organisms. However, housemaids operating inside a kitchen can be the source of infection. In addition, hand hygiene among housemaids working in dwellings was underexplored. This study aimed to assess the hand hygiene status and associated factors among housemaids working in communal living residences in Jimma City, Southwest Ethiopia.

Methods

A total of 230 housemaids were included in this cross-sectional study. Total samples were proportionally allocated for each residence and a simple random sampling technique was applied to select the study participants. Hand hygiene status and relevant characteristics were collected through face-to-face interviews and observations. Hand swab samples were collected and tested for bacterial contaminants. Then, it was inoculated aseptically using streak-plating methods on mannitol salt agar (MSA), MacConkey agar (MCA), salmonella-shigella agar (SSA), and eosin methylene blue (EMB) agar and then incubated at 37 °C for 24 h. Data was edited, cleaned, and double-entered into Epidata version 3.1 and then exported to the statistical package for social science statistics version 26 for further analysis. Binary logistic regression was used to identify associated factors. Statistically significant was declared at P value < 0.05.

Results

Two hundred twenty-five housemaids were interviewed with a response rate of 97.8 %. The results showed that the proportion of good hand hygiene status among the housemaids was only 28.0 %. Although the majority of participants reported washing their hands frequently, the prevalence of bacterial contaminants on their hands was high at 72 %. The study identified several factors associated with hand hygiene status, including the occupational status of heads of households (AOR = 0.030, 95 % CI: 0.003, 0.348; P = 0.0050), the effectiveness of the heads of household (AOR = 13.955, 95 % CI: 1.442, 13.500; P = 0.0230), and the removal of accessories during handwashing (AOR = 20.844, 95 % CI: 2.190, 9.842; P = 0.0080).

Conclusion

Overall, the hand hygiene status of housemaids was found to be poor and influenced by demographics and other relevant characteristics. The study emphasizes the need for a multimodal strategy involving household heads, local and national authorities, and other stakeholders to raise awareness and advocate for hand hygiene to prevent communicable diseases in the wider community, particularly in the study area.

Effect of handwashing on the reduction of Escherichia coli on children's hands in an urban slum Indonesia

Poor hand hygiene practice has been linked to an increase in the number of infections among children in urban slums. Hands are considered an intersection for bacterial transmission, but it is unclear whether the handwashing technique affects bacteria elimination. This study investigated the effect of handwashing on the concentration of Escherichia coli (E. coli) and factors related to its reduction among children in an urban slum in Bandung, Indonesia. We observed handwashing and conducted repeated hand swabs before and after handwashing among 137 participants. The mean E. coli concentration on the hands decreased after handwashing, with a higher reduction in E. coli count among students who used soap and had soap contact for more than 10 s during handwashing. Cleaning in-between fingers, using soap, soap contact for more than 10 s, and drying hands with a single-use towel were effective factors for reducing E. coli concentration after handwashing (p < 0.05). More than half of the swab samples (59%) tested positive for E. coli after handwashing, indicating that the children's handwashing technique was not effective in completely removing E. coli from the hands. Moreover, sustained and consistent handwashing practice as a daily behavior in children would maximize the effect.

Handwashing Practice of Food Establishment Customers, Microbial Quality of Handwashing Water, and Associated Factors in Ginjo Kebele, Jimma Town, Southwest Ethiopia

Handwashing plays a major role in preventing the spread of infection and, if poorly implemented, leads to different illnesses. However, the quality of water meant for handwashing and handwashing practice and hand hygiene conditions of food establishment customers are overlooked issues, unlike drinking water and hygienic conditions and practice of food handlers. This study aimed to assess the microbial quality of water used for handwashing and hygienic practice and the status of customers of food establishments and associated factors in Ginjo Kebele, Jimma town, Southwest, Ethiopia. A cross-sectional study design was employed in July 2022. Forty water and 40 hand swab samples were taken and analyzed for total coliform and E. coli using the spread plate method. Handwashing facility conditions and the handwashing practices of customers were assessed using a checklist and questionnaire. The data were analyzed by SPSS version 23 software. The median handwashing water total coliform count was 390.0 CFU/ml. The median hand swab samples' total coliform and E. coli load were 21.6 and 4.8 CFU/cm², respectively after handwashing practice. There was an uphill correlation between the handwashing water and hand swab sample total coliform load (r = .34, P = .032). The mean handwashing efficacy for the removal of total coliform was 25.8%. The microbial load was varied with the type of water container used, method of taking water from the container, handwashing practice, and hand drying. The microbial quality of handwashing water and hand swab samples didn't comply with the acceptable limit. Thus, governmental bodies should work to improve the handwashing practice of communities. Food establishment owners should treat water for handwashing, clean the water containers, handle the water properly, and avail soap and poster demonstrators to the handwashing facilities. The customers should also comply with proper hand washing practices and reduce hand contamination.

Evaluating knowledge, awareness and associated water usage towards hand hygiene practices influenced by the current COVID-19 pandemic in Bangladesh

Hand hygiene is considered as one of the most effective ways for preventing transmissible diseases, especially for preventing virus-borne diseases. The study has been conducted to evaluate changes in knowledge, awareness and practices of hand hygiene due to the outbreak of the coronavirus disease (COVID-19) in Bangladesh. The potential factors influencing human behaviours for maintaining hand hygiene have also been explored. Moreover, a probable increase in daily water demand associated with the changed situation has been assessed. An online survey was performed among a total of 367 Bangladeshi residents about their practices of hand hygiene during pre-corona, corona, and of their perceived future practices at post-corona period. It has been observed that a significant percentage (62.1%) of the respondents have received basic hygiene education at any level of their academic education. Nevertheless, their hygiene practices were very poor before the COVID-19 pandemic. The outbreak of the COVID-19 has reinforced their previous knowledge and greatly influenced their behavioural changes towards practicing hand hygiene as per World Health Organization guidelines for preventing the virus outbreak. The changes, however, have created increased water demand. The estimated water usage is found to be 2.68 times (9.15 L/c/d) and 2.52 times (8.59 L/c/d) higher in the corona and post-corona period respectively than that of the pre-corona situation (3.41 L/c/d). The principal component analysis (PCA) elucidated that an individual's practice of hand hygiene was associated with income, level of academic and hygiene education, and the COVID-19 outbreak itself. Moreover, the influence of hygiene education and COVID-19 outbreak affecting the duration of handwashing are found highly significant (p-value < 0.001) from the regression analysis. Raising awareness towards behavioural change of an individual about water usage, improvement of academic curriculum regarding hand hygiene and provision of water pricing are recommended to attain sustainable development goals of the country.

Evaluation of the Effect of Wastewater Irrigation on the Microbiological Quality of Vegetables in Northeast Ethiopia: Implication for Food-Borne Infection and Intoxications

BACKGROUND

Cultivation of vegetables using untreated wastewater is a common phenomenon in many drought-prone areas of the world. Consumption of such microbiologically unsafe vegetable increase the risk of food-borne diseases. As a result, evaluating the effect of wastewater irrigation on the microbiological quality of vegetables would be beneficial to consumers' health.

METHOD

A total of 192 vegetable samples (lettuce, cabbage, carrot, and tomato) and 64 irrigation water samples were collected and analyzed for total bacteria and coliform count using a standardized protocol over a 4 month period. One-way analysis of variance and Pearson correlation coefficient was used to analyze the data. Statistical significance was defined at a P-value of less than 0.05.

RESULT

Carrots were the least polluted vegetable, according to the study, while cabbage had the highest contamination levels. The mean bacterial count among the vegetables differs significantly (P < 0.05). The fecal coliform counts of the irrigation wastewater exceed the international wastewater irrigation standards. The mean microbial count between vegetables and water samples showed a significant positive relationship (P < 0.05). All of the analyzed vegetable samples were of borderline microbial quality for fecal coliform bacteria.

CONCLUSION

Irrigation wastewater has a low microbiological quality, which significantly contributes to the contamination of vegetables grown on it.

RECOMMENDATION

Measures should be taken to improve the microbial quality of wastewater as well as the quality of vegetables grown in order to protect consumers' health from food-borne diseases.

Effects of local handwashing agents on microbial contamination of the hands in a rural setting in Northwest Ethiopia: a cluster randomised controlled trial

OBJECTIVE

To evaluate the effectiveness of handwashing with water and wood ash in reducing faecal contamination of the hands.

DESIGN

A cluster randomised controlled trial was employed with two arms: handwashing with water and wood ash versus handwashing with water alone.

SETTING

Rural households of East Dembiya District, Central Gondar Zone, Amhara National Regional State, Ethiopia.

PARTICIPANTS

440 mothers and caregivers of children younger than 5 years assigned (1:1, 220 in each group) in clusters, with buffer zones between each cluster.

INTERVENTION

Health education on effective handwashing was given to the intervention and control groups. Participants in the intervention group used wood ash of the same quantity (ie, one closed palm).

OUTCOME MEASURES

The primary outcome was microbial contamination of the hands, measured by means of Escherichia coli counts before and after handwashing.

RESULTS

At baseline, 75.9% and 67.7% of the participants in the intervention and control groups, respectively, had dirt on their fingernails, and the hands of all participants in both groups were contaminated with E. coli. The mean E. coli counts recovered at baseline were 3.07 log10 colony forming unit (CFU)/swab in the intervention group and 3.03 log10 CFU/swab in the control group, while at endline it was 1.4 log10 CFU/swab in the intervention group and 3.02 log10 CFU/swab in the control group. The mean E.coli counts was reduced by 1.65 log10 due to the intervention (difference-in-differences: β= -1.65, 95% CI= -1.84 to -1.46).

CONCLUSION

Two-thirds of the swab samples tested positive for E. coli after handwashing with water and wood ash, which indicates wood ash is not very effective in terms of completely removing micro-organisms on the hands. However, wood ash was significantly better than water alone in reducing the concentration of faecal coliform organisms on the hands. Local health authorities should primarily promote handwashing with soap. However, in the absence of soap, use of wood ash over water alone might be appropriate.

TRIAL REGISTRATION NUMBER

PACTR202011855730652.

Occurrence, Risk Factors, and Antimicrobial Susceptibility Test of Thermophilic Campylobacter Species of Bovine Carcass at Municipal Abattoir and Butcher Shops of Jimma Town, Southwest Ethiopia

BACKGROUND

Although Campylobacter jejuni (C. jejuni) and Campylobacter coli (C. coli) cause acute diarrheal diseases in people all over the world, they are most commonly seen in other mammalian species and are a seemingly healthy carrier condition. Humans in Ethiopia, on the other hand, are largely unaware of the existence of Campylobacter in food animals as potential sources of infection.

OBJECTIVE

To determine the occurrence, risk factors, and antimicrobial susceptibility pattern of thermophilic Campylobacter species in bovine raw meat from the abattoir and butcher shops.

METHODS

Swab samples were collected from 177 cattle carcasses (from abattoir 93 and butcher shops 84) and cultured using standard methods. An antimicrobial susceptibility test was performed using the disk diffusion method towards eleven antimicrobial agents.

RESULTS

The overall prevalence of thermophilic Campylobacter species was 14 (7.9%). From these, 11 (78.6%) were identified to be C. jejuni and 3 (21.4%) were C. coli. Lack of handwashing before meat processing and after visiting the toilet, meat contact with floors, walls, or soiling during preparation, and lack of training were the most important factors independently associated with (p<0.05) the prevalence of Campylobacter species contamination. The highest level of antimicrobial resistance of the Campylobacter isolates was recorded to ampicillin (10μg) (100%), followed by amoxicillin (30μg) (78.6%) and sulphamethoxazole-trimethoprim (57.1%) while the least resisted antimicrobials were streptomycin (25μg), erythromycin (15μg), oxytetracycline (30μg) (each 28.6%), kanamycin (30μg) 14.3%, chloramphenicol (30μg) and gentamycin (10μg) (each 7.1%).

CONCLUSION

Despite the low prevalence of thermophilic Campylobacter in the current investigation, it may pose a significant public health threat. As a result, it is vital to give retailers and customers extensive education, training, and knowledge about the correct handling and cooking of animal-derived goods. Furthermore, antimicrobials should be used with caution in both veterinary and human treatment regimens as well as a wider examination of antimicrobial resistance patterns for the use of well-targeted antimicrobials.