Prevalence of bacteria and intestinal parasites among food-handlers in Gondar town, northwest Ethiopia

Prevalence of Intestinal Parasitic Infections and Associated Factors Among Food Handlers in East Africa: A Systematic Review and Meta-analysis

BACKGROUND

Intestinal parasitic infections are a significant public health concern, especially among food handlers, who can transmit these infections to the public through food preparation and handling. This systematic review and meta-analysis aimed to determine the pooled prevalence and associated factors of intestinal parasitic infections among food handlers in the East African region.

METHODS

A systematic review and meta-analysis on intestinal parasitic infections among food handlers involved a comprehensive search across various databases, including Scopus, PubMed, ScienceDirect, Google Scholar, and the institution's library registers. Forty relevant articles were identified and analyzed using STATA Software version 17.0. Sensitivity analysis, publication bias assessment with Egger's test, and the Trim-and-fill meta-analysis for bias adjustment were conducted. Heterogeneity across the studies was assessed using Cochran's Q statistic and I2 statistics, and subgroup analysis computed for significant heterogeneity (I2 value ≥ 50%). A random effect model was used to determine the pooled prevalence of intestinal parasitic infections.

RESULTS

The pooled prevalence of intestinal parasitic infections among food handlers was 32.27% (95% CI 27.90-36.65). The most prevalent parasites were Entamoeba histolytica/dispar 20.83% (95% CI 13.66-28%), Ascaris lumbricoides 13.84% (95% CI 10-17.68%), Giardia lamblia 8.55% (95% CI 6.03-11.06%), and hookworm 6.43% (95% CI 3.93-8.93%). Using a common knife for cutting raw meat (AOR = 2.27, 95% CI 1.21-4.31), food handler's untrimmed fingernails (AOR = 2.14, 95% CI 1.50-2.78), and no hand washing practices with soap after using the toilet (AOR = 2.25, 95% CI 1.33-3.18) were associated with higher rates of intestinal parasitic infections among food handlers.

CONCLUSIONS

Parasitic infections among food handlers were found to be significantly prevalent. Factors contributing to this high prevalence included food handlers' untrimmed fingernails, poor hand hygiene practices, and using a shared knife for chopping various food items, including raw meat. These findings emphasize the need for proper personal hygiene and sanitation practices among food handlers to prevent transmitting parasitic infections to consumers.

Isolation and antimicrobial susceptibility profile of Salmonella species from slaughtered cattle carcasses and abattoir personnel at Dessie, municipality Abattoir, Northeast Ethiopia

BACKGROUND

Antibiotic-resistant Salmonella is one of the main public health concerns in the world. Isolation of Salmonella in abattoirs has been considered the core source of infection in the community from meat. Still, there is limited information on the contamination rate of cattle carcasses.

OBJECTIVE

This study aimed to document the occurrence and antimicrobial susceptibility profile of Salmonella species recovered from cattle carcass and abattoir personnel at Dessie, municipality abattoir, Northeast Ethiopia: METHODS: A total of 336 carcass swabs of abdomen, neck, and hind limb from cattle carcasses and 24 stool samples were collected from abattoir personnel using a systematic sampling method from February to April 2019. The collected samples were transported using Cary-Blair transport media and cultivated on Selenite cysteine F-broth, Brilliant green agar, and Xylose-lysine deoxycholate agar plates to isolate Salmonella species. Gram stain, colony morphology, and biochemical tests were performed to identify the isolated bacteria. An antimicrobial susceptibility test for Salmonella was performed using the Kirby-Bauer Disc Diffusion method. Descriptive statistics; both bivariable and multivariable logistic regression analysis was performed using SPSS version 25 software. P-value < 0.05 at 95% CI was considered statistically significant.

RESULTS

The prevalence of salmonella species was 8%(27/336) from all samples.'The prevalence of Salmonella isolates in cattle carcass and abattoir personnel was 8%(25/312) and 8.3%(2/24) respectively. The antimicrobial test showed that Salmonella species were 100% resistant to ampicillin, 59.3% to trimethoprim-sulfamethoxazole, 59.3% to tetracycline, and 55.6% to amoxicillin/clavulanate. From the total antimicrobial tested bacteria, 81.5%(22/27) were resistant to three and above classes of antibiotics (drug classes). Unwashed knives, carcasses, and hands of butchers during slaughtering were significantly associated (p < 0.05) with Salmonella found in carcasses.

CONCLUSIONS

Salmonella isolation rates from cattle carcasses were high, with the bacteria showing notable resistance to most tested antibiotics. Poor hygiene practices, unsanitized equipment, and unhygienic beef processing were contributing factors.

Prevalence, antibiotic susceptibility, and genomic analysis of Vibrio alginolyticus isolated from seafood and freshwater products in China

Introduction

This study characterized Vibrio alginolyticus isolated from seafood and freshwater products in China (2020).

Methods and Results

In total, 122 (95.31%) V. alginolyticus isolates were resistant to at least 1 antibiotic category, and 2 (1.56%) isolates were resistant to at least 3 antibiotic categories and belong to multi-drug resistance (MDR) isolates. A high prevalence rate was observed to be blaCARB (98.04%) encoding beta-lactam resistance, followed by tet (97.06%) encoding tetracycline resistance and fos (4.90%) encoding resistance to fosfomycin. Among the 57 V. alginolyticus isolates, the commonest virulence genes were type III secretion system translocated gene vopD, vopB, and vcrH (54.4%, 31/57), type III secretion system regulated gene tyeA (54.39%), followed by vscI and vscF (50.88%) encoded type III secretion system inner rod protein and needle protein, respectively. Multilocus sequence typing (MLST) showed considerable genetic diversity, with 34 distinct sequence types (STs) identified among 55 isolates. ST421 (n = 5), ST166 (n = 4), ST523 (n = 3), ST516 (n = 3), and ST507 (n = 3) were dominant STs among 55 V. alginolyticus isolates.

Discussion

These findings highlight the widespread occurrence of V. alginolyticus in both freshwater and seafood products, underscoring the critical need for vigilant monitoring of these bacteria. Such measures are essential for ensuring effective food safety management and safeguarding public health.

Burden and factors influencing intestinal parasitic infections among food handlers in Gondar City, Northwest Ethiopia

Background

Intestinal parasitic infections pose significant global health challenges, particularly in developing countries. Asymptomatic infections often present a considerable burden with food handlers serving as potential carriers. In Ethiopia, the prevalence of these parasites varies across regions, and accurate data in the study area is lacking. Therefore, this study aimed to investigate the prevalence of intestinal parasites among food handlers working in hotels and restaurants in Gondar City, Northwest Ethiopia.

Methods

A cross-sectional study collected stool samples from food handlers alongside a structured questionnaire gathering socio-demographic and hygiene practice information. Stool specimens were screened for intestinal parasites using direct wet mount and formol-ether concentration techniques. The collected data were checked for completeness, entered into EpiData software version 3.1, and exported to SPSS version 20 for analysis. A multivariable logistic regression analysis was deemed statistically significant if the p-value was less than 0.05.

Results

A total of 257 food handlers working in hotels and restaurants in Gondar City participated in the study. Of these, 33.5% (86/257) were found positive for one or more intestinal parasites, with a 95% confidence interval (CI) of 28.0-39.5%. The study identified nine types of intestinal parasites, with E. histolytica/dispar (8.2%, 21/257) and Ascaris lumbricoides (6.6%, 17/257) being the predominant parasites, followed by hookworm (3.5%, 9/257) and S. mansoni (2.3%, 6/257). The prevalence of mixed infections was 9.3% (24/257). A significant association was observed between intestinal parasitic infection and the educational level of food handlers.

Conclusion

In this study, a high prevalence of intestinal parasites was detected indicating poor hygiene practices of the food handlers at the study site. Even the prevalence of mixed infections was high. Regular training, strict adherence to personal hygiene and food-handling practices, and routine inspections and medical checkups for food handlers are crucial.

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.

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.

Advances in the Development of Carbonic Anhydrase Inhibitors as New Antiprotozoal Agents

BACKGROUND

Parasitic diseases are a public health problem despite the existence of drugs for their treatment. These treatments have variable efficacy and, in some cases, serious adverse effects. There has been interest in the enzyme carbonic anhydrase (CA) in the last two decades since it is essential in the life cycle of various parasites due to its important participation in processes such as pyrimidine synthesis, HCO3 - transport across cell membranes, and the maintenance of intracellular pH and ion transport (Na+, K+, and H+), among others.

OBJECTIVE

In this review, CA was analyzed as a pharmacological target in etiological agents of malaria, American trypanosomiasis, leishmaniasis, amoebiasis, and trichomoniasis. The CA inhibitors´ design, binding mode, and structure-activity relationship are also discussed.

CONCLUSION

According to this review, advances in discovering compounds with potent inhibitory activity suggest that CA is a candidate for developing new antiprotozoal agents.

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.

Prevalence and Associated Factors of Intestinal Parasites among Food Handlers Working in Food Service Establishments in Northwest Ethiopia, 2022

Background

As in most of African countries, intestinal parasites have been widely distributed in Ethiopia and are among the 10 top causes of morbidity and mortality nationwide. Statistics for food-borne illness in various industrialized countries show that up to 60% of cases may be caused by poor food handling techniques and by contaminated food served in food service establishments. Epidemiological information on the prevalence of various intestinal parasitic infections in different regions/localities is a prerequisite to develop appropriate strategies.

Objective

This study aimed to determine the magnitude of intestinal parasites among food handlers working in different food service establishments in Gondar city.

Methods

A cross-sectional study was conducted with food handlers working in different food service establishments in Gondar city. Stool samples were collected from 350 food handlers and processed using the formol-ether concentration method and then microscopically examined for intestinal parasitic infections. Pre-tested and structured questionnaire was used to study the socio-demographic characteristics of food handlers. Chi-square test and p-value were used to assess the associations between risk factors and the parasite isolation rate. The p-value ≤0.05 was considered as statistically significant.

Results

Of the 350 food handlers, 160 (45.71%) had parasites. Among the isolated parasites, Ascaris lumbricoides was found to be the most prevalent parasite 35.63%, followed by hookworm 19.38%, Entamoeba histolytica/dispar 16.25%, Trichuris trichiura 10.00%, Strongyloides stercoralis 8.13%, Schistosoma mansoni 6.88%, and Cystoisospora belli, Hymenolepis nana, and Taenia species each accounting 1.25%.

Conclusion

The result of the study indicated that the magnitude of intestinal parasitosis among food handlers working at different levels of food establishments in Gondar, Ethiopia, was found to be high. Being at lower educational level and inactive role of the town's municipality are determined as a risk factor for parasitic positivity of food handlers.

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 (I 2), 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.

Bacteriological Quality and Public Health Risk of Ready-to-Eat Foods in Developing Countries: Systematic Review and Meta Analysis

Background

Ready-to-eat foods are foods that are consumed at the point of sale or later, without any further processing or treatment. Foodborne diseases are on the rise worldwide, involving a wide range of diseases caused by pathogenic bacteria, and are becoming a public health problem. Therefore, this study sought to identify and determine the bacteriological quality and public health risks in ready-to-eat foods in developing countries.

Methods

The studies published from 2012 to 2020 were identified through systematic searches of various electronic databases such as Google Scholar, PubMed and MEDLINE, MedNar, EMBASE, CINAHL, Scopus, and Science Direct. The articles were searched using a Boolean logic operator ("AND," "OR," "NOT") combination with Medical Subject Headings (MeSH) terms and keywords. All identified keywords and an index term were checked in all included databases. In addition, a quality assessment is performed to determine the relevance of the article, and then the data are extracted and analyzed.

Results

The current study found that the pooled prevalence of Staphylococcus aureus, Enterobacter species, Klebsiella, Escherichia coli, Salmonella, Bacillus cereus, Pseudomonas species, and Shigella in ready-to-eat foods was 30.24% (95% CI: 18.8, 44.65), 11.3% (95% CI: 6.6, 18.7), 9.1% (95% CI: 7.0, 11.8), 23.8% (95% CI: 17.5, 31.5), 17.4% (95% CI: 11.6, 25.31)], 26.8% (95% CI: 13.7, 45.9), 6.1% (95% CI: 2.8, 12.6), 34.4% (95% CI: 18.1-55.4), respectively.

Conclusions

Most of the reviewed articles reported on various pathogenic bacterial species that are potentially harmful to human health, such as Staphylococcus aureus, Salmonella, Shigella, and Escherichia coli in ready-to-eat food above the maximum allowable limit. Therefore, relevant national and international organizations must take corrective measures to prevent foodborne diseases and protect human health.

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.

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.

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.

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.

Evaluating Food Safety Compliance and Hygiene Practices of Food Handlers Working in Community and Healthcare Settings in Kuwait

Safe food handling and proper hygiene practices performed by food handlers (FHs) in catering establishments are fundamental elements in reducing foodborne diseases. This study aimed at assessing food safety knowledge and compliance of hygiene practices of FHs within food establishments (using a structured questionnaire). A cross-sectional study was carried out from May 2016 to March 2018 on FHs working in community and healthcare settings. A total of 405 FHs, including 44.9% and 55.1%, were working in community and healthcare settings, respectively. The majority, 84.7%, were males with a ratio of 5.5:1. Most of them, 84.4%, had a high school education and above. A greater number, 44%, of FHs were in the age bracket of 29-39 years. As high as 95.6% of them underwent a regular medical check-up. Unsafe attitudes were shown by 44.9%% who used the same hand gloves while handling raw meat and fresh food. Additionally, 42% went home with their uniforms. The hygiene assessment score was 95.8%. In general, FHs have adequate knowledge and compliance with food safety practices. It is recommended that regular and ongoing training on hygienic practices and proper food safety techniques must be given to all FHs to ensure food safety.

Prevalence and factors associated with intestinal parasites among food handlers in Medebay Zana District, north West Tigray, northern Ethiopia

INTRODUCTION

Intestinal parasites are amongst the major public health challenges facing Sub-Saharan Africa. The aim of the study was to determine the prevalence of intestinal parasites and its associated factors among food handlers in Medebay Zana District, Tigray, Ethiopia.

METHODS

A cross-sectional study was conducted among 401 food handler individuals selected by systematic random sampling. Binary and multivariable logistic regression was used to determine the possible association between the independent variable and outcome variables. Statistical significance was declared at p-value < 0.05 with a 95% confidence interval.

RESULT

The prevalence of intestinal parasites was 33.2% within this sample. The dominant parasite was Entamoeba coli 50(37.4%), followed by Entamoeba histolytica/dispar 24(18%), Entamoeba hartmanni 18(13.5), Giardia lamblia 17(12.8%), Schistosoma mansoni 8(6%), Hymenolepis nana 7(5.3%), Entervious vermicularies 6(4.5%) and Taenia species 3(2.5%).

CONCLUSION

This study revealed a high prevalence of intestinal parasites among food handlers for a range of intestinal parasites. The significant predictors were the source of water, washing hands before food preparation, washing hands with soap and water after visiting the toilet, shower installation at the workplace, washing the body regularly and eating raw vegetables and raw meat. Hence, local health planners should implement appropriate interventional measures for the novel risk factors to mitigate the problem.

Socio-demographic influences on the prevalence of intestinal parasitic infections among workers in Qatar

Background

The rapid growth of Qatar in the last two decades has been associated with an enormous expansion of building programs in its cities and in the provision of new service industries. This in turn has attracted a large influx of immigrant workers seeking employment in jobs associated with food handling, domestic service, and the building industry. Many of these immigrants come from countries in the tropics and subtropics where intestinal parasitic infections are common. In this study, we explored the environmental and socio-demographic characteristics of immigrant workers in Doha Qatar, which might explain the persistence of the parasites that they harbor.

Methodology

This cross-sectional survey was conducted among 2486 newly arrived immigrant workers and those who visited Qatar previously during the period 2012–2014. Through questionnaires and census data, we characterized the socio-demographic conditions at an individual, family, and neighborhood levels.

Results

Overall, the prevalence of combined protozoan infection was 11.7% and that of helminth was 7.0%. Combined protozoan infections were significantly associated with immigrant workers arriving in Doha for the first time. In univariate log-linear statistical models fitted in phase 1 of the analysis, significant associations were observed between the prevalence of combined protozoan infections and personal and familial factors that included religion, the level of education of subjects, both parents’ educational levels and their jobs, and the number of siblings. Furthermore, environmental effects on the prevalence of protozoan infections including the country of origin, the floor of the house, toilet type, household content index, provision of household water, farming background showed strong associations with protozoan infections. However, in phase 2, multifactorial binary logistic generalized linear models focusing only on the significant effects identified in phase 1, showed that only five factors retained significance (age class, floor of the house, household contents index, father’s education, and the number of siblings). The only factors that had a significant effect on the prevalence of helminth infections were the subjects’ age class and the mother’s educational level.

Conclusions

The prevalence of intestinal protozoan parasites among immigrant workers in Qatar is clearly multifactorial in origin determined by key familial relationships of subjects and also the environment, in which the subjects lived prior to their arrival in Qatar. Moreover, our results suggest that screening protocols for applicants for visas/work permits need to be revised giving more careful attention to the intestinal protozoan infections that potential immigrant workers may harbor.

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 of Methicillin-Resistant Staphylococcus aureus and Classical Enterotoxin Genes Among Sudanese Food Handlers

Food handlers who carry enterotoxin-producing Staphylococcus aureus could become potential reservoirs of Staphylococcal food poisoning. The study is a cross-sectional one aimed to determine the prevalence of methicillin-resistant S. aureus (MRSA) and staphylococcal enterotoxins from randomly selected food handlers in Al Jazirah state, Sudan. Culture swabs were collected from the hands and nasals of food handlers (2016-2018). Identification of S. aureus was done on the basis of conventional laboratory tests. All S. aureus isolates were screened for MRSA and staphylococcal enterotoxin (SE) genes by polymerase chain reaction. The S. aureus strains were isolated from 25% of the collected culture swabs of which 42% were confirmed as MRSA. The existence of one or more of enterotoxin genes was confirmed in 34.4% of the isolated S. aureus strains. The combined staphylococcal enterotoxin genes were found in 9.6% of the isolates. The SE genes among MRSA strains (61.5%) were found to be higher than methicillin-sensitive S. aureus strains (14.8%). The most frequent staphylococcal enterotoxin genes were SEA (19.4%) followed by the SEB (8.6%), SEC (4.3%), and SED (2.1%). The carriage rate of MRSA strains demonstrated a higher rate of staphylococcal enterotoxins genes than methicillin-sensitive S. aureus. There is an increasing prevalence of MRSA compared with the previous rates and staphylococcal enterotoxin genes among Sudanese food handlers, which is a serious problem for public health. 

Food Hygiene Practice and Its Determinants Among Food Handlers at University of Gondar, Northwest Ethiopia, 2019

Introduction

Food hygiene is an essential matter of public health for protecting or preventing diseases caused by unsafe food due to lack of good quality from production to consumption.

Objective

The current study aimed at assessing the food hygiene practice and determinant factors among food handlers working at the University of Gondar.

Methods

Univariate and multivariable binary logistic regression analyses were used to test the association of covariates with the food safety practice. Variables with p-value <0.2 were candidates for multivariable analysis. The adjusted odds ratio with 95% confidence interval and p-values less than 0.05 were used to report associations in the final model.

Results

A total of 184(46.7%) of the study subjects had good self-reported food hygiene practice. Being male [Adjusted odds ratio (AOR): 2.37, 95% confidence interval (CI) (1.34, 4.19)], educational status (primary [AOR: 2.54, 95% CI (1.16, 5.58)] and secondary [AOR: 2.20, 95% CI (1.11, 4.37)]), workers with greater than 2 years work experience [AOR: 1.86, 95% CI (1.06, 3.25)], monthly income of 2044–4867ETB/month [AOR: 2.05, 95% CI (1.01, 4.16)] were independent predictors of food safety practice of food handlers.

Conclusion and Recommendations

Below half of the study subjects had good self-reported food hygiene practice. Sex, educational status, and income were factors associated with the food hygiene practice. There should be continuous supportive supervision to raise the skills of food handlers to comply to better food hygiene practice. Food hygiene training should be given especially to female food handlers. Frequent audits are also required to ensure the permanence of effective and continuous training. Regular medical check up and strict hygiene follow-up should be encouraged to prevent foodborne disease outbreaks at universities.

Prevalence of Microorganisms of Public Health Significance in Ready-to-Eat Foods Sold in Developing Countries: Systematic Review and Meta-Analysis

Background

The issue of microbial quality and safety of ready-to-eat foods has become a public health concern that needs to be addressed to protect the consumer's health. Contamination of ready-to-eat foods by enteric pathogens such as Escherichia coli, Salmonella, and Staphylococcus aureus bacteria is associated with potential health risks and can cause foodborne outbreaks. Thus, the systematic review and meta-analysis aimed at determining the overall evidence on the prevalence of microorganisms of public health significance in ready-to-eat foods based on previous studies.

Methods

The articles published from 2015 to 2020 were searched from multiple electronic databases such as PubMed, Google Scholar, MEDLINE, CINAHL, Science Direct, Web of Science, and the Directory of Open Access Journals. The JBI critical appraisal tool was applied to the included articles. To determine the heterogeneity among the included articles, I² statistics were used while publication bias was evaluated using the visual funnel plot. A Forest plot using the random effect model for meta-analysis was used to estimate the pooled prevalence of E. coli, Salmonella, and S. aureus in ready to eat foods.

Results

The pooled prevalence of E. coli, Salmonella, and S. aureus in ready to eat foods was 33.8% (95% CI: 19.9, 51.2; Q value = 67.080, I² = 89.56%), 26.0% (95% CI: 13.8, 43.6%; Q value = 83.67, I² = 91.63%), and 46.3% (95% CI: 24.8, 69.4%, I² = 94.9%), respectively.

Conclusion

The findings show that contamination of ready-to-eat foods with pathogenic microorganisms continues to be a public health risk. Thus, effective food hygiene and safety systems are necessary to protect the health of the consumers and the public as a whole.

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

Background

Human intestinal protozoan parasitic infections (HIPPIs) are a series of public health problems in developing countries like Ethiopia. The overall prevalence of HIPPIs in Ethiopia is not known. Therefore, this systematic review and meta-analysis study is aimed at determining the overall prevalence of HIPPIs in Ethiopia.

Methods

Articles written in English were searched from online public databases. Searching terms used were "prevalence," "intestinal protozoan parasite," "associated factors," and "Ethiopia." We used Stata version 14 for meta-analysis and Cochran's Q test statistics and the I ² test for heterogeneity.

Result

A total of 286 articles were reviewed, but only 45 of them fulfilled the inclusion criteria. The pooled prevalence of HIPPIs in Ethiopia was 25.01% (95% CI: 20.08%-29.95%) where Entamoeba histolytica/dispar is the most prevalent (14.09%, 95% CI: 11.03%-17.14%) followed by Giardia lamblia (10.03%, 95% CI: 7.69%-12.38%) and Cryptosporidium spp. (5.93%, 95% CI: 2.95%-8.91%). This meta-analysis showed that family size (OR: 3.7, 95% CI: 1.45-5.85), source of drinking water (OR: 3.33, 95% CI: 1.30-5.36), open field defecation (OR: 2.91, 95% CI: 1.60-4.21), handwashing habit (OR: 2.82, 95% CI: 2.01-3.63), playing with soil (OR: 2.15, 95% CI: 1.01-3.29), the habit of eating raw vegetables (OR: 1.77, 95% CI: 1.03-2.51), and fingernail trimming (OR: 1.70, 95% CI: 0.89-2.25) were strongly associated with the HIPPIs in Ethiopia. High heterogeneity on the prevalence of HIPPIs was observed among studies within and among regions (I ² > 99% and P ≤ 0.01).

Conclusion

The prevalence of HIPPIs was significantly high among the Ethiopian population. Family size, source of drinking water, open field defecation, handwashing habit, the habit of eating raw vegetables, and fingernail trimming habits were significantly associated with HIPPIs.

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.

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.

Nasal and Hand Carriage Rate of Staphylococcus aureus among Food Handlers Working in Jimma Town, Southwest Ethiopia

Background

Food handlers have been recognized to play a major role in the transmission of food borne diseases, contributing significantly to the global incidence and burden of the diseases. This study, therefore, aimed to assess the nasal and hand carriage of Staphylococcus aureus among food handlers in Jimma Town.

Methods

A community based cross sectional study was conducted from February to May 2017. Swab specimens from nasopharyngeal and hands of food handlers working in food establishments were collected for isolation and identification of S. aureus using standard bacteriological methods. Antimicrobial susceptibility test was done using disc diffusion method. Associations of selected variables for S. aureus colonization were determined using SPSS version 20 with p ≤ 0.05 taken as statistically significant.

Results

Among the 300 food handlers working in hotels and restaurants in Jimma Town, 86(28.7%) were colonized by S. aureus. The frequency of isolation of S. aureus from nose, hand and both parts (nose and hand) were 27(9%), 34(11.3%) and 25(8.3%), respectively. There was strong association (P=0.00336) between carriage rate of S. aureus and food handlers' job category. The majority (90.7%) of the isolates were resistant to Penicillin and Ampicillin. Increased levels of sensitivity were observed against Ciprofloxacin (96.5%), Cefoxitin (95.3%) and Amoxicillin-Clavulanic Acid (94.2%).

Conclusions

This study revealed a high prevalence of S. aureus carriers among food handlers and high antibacterial resistance towards commonly prescribed drugs, justifying the screening of food handlers to detect and treat carriers and protect restaurant customers from staphylococcal food poisoning.

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.

Intestinal parasite infections and associated factors among inmates of Arba Minch prison, southern Ethiopia: cross sectional study

Background

Intestinal parasitic infection is one of the parasitic infections affecting people living in prison. Helminths and intestinal protozoan infections are the most common parasitic infection that may cause serious life-threatening diseases in inmates living in developing countries. This study was aimed to investigate the prevalence and associated factors of intestinal parasitic infections (IPIs) among inmates living in Arba Minch prison, southern Ethiopia.

Methods

Institutional based cross sectional study was conducted on Arba Minch inmates, southern Ethiopian. Pre-tested semi-structured questionnaire was used to gather the data of socio-demographic characteristics, hygiene status of the prisoners, sanitation condition of the prison, and associated factors for IPIs by face to face interview. Direct wet-mount examination and formol-ether sedimentation techniques were used to examine intestinal parasitic infection from stool specimens. Binary logistic regression analysis was used to see the association between different variables and the IPI. Odds ratio with 95% CI was computed to determine the presence association and strength of the associated factors.

Result

A total of 320 prisoners were participated in this study. Of these, 154(48.1%) of them were infected with one or more intestinal parasites. Eight different intestinal parasites species were identified and Giardia lamblia was the predominant parasite. Among infected inmates, nearly one out of four of them had multiple parasitic infections dominated by Giardia lamblia and E. histolytica/dispar co-infection. Sleeping in group [AOR = 1.9; 95% CI: (1.0–3.8)], married prisoners [AOR = 1.8; 95% CI: (1.1–2.9)], and hand washing habits after handling soil [AOR = 2.4; 95% CI: (1.0–5.6)] were independently associated with IPI.

Conclusion

High prevalence of intestinal parasitic infection was detected in Arba Minch inmates, southern Ethiopian. Absence of hand washing, marital status, and way of sleeping were the factors associated with the IPI. Implementation of mass drug administration, education on water, sanitation and hygiene (WASH) and periodic screening of intestinal parasitic infection is very important to reduce the high prevalence IPIs in prison.

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.

Strongyloidiasis in Ethiopia: systematic review on risk factors, diagnosis, prevalence and clinical outcomes

BACKGROUND

Strongyloidiasis is a gastrointestinal infection caused by the parasitic nematode Strongyloides stercoralis. It is estimated to infect up to 370 million people globally and is predominately found in tropical and subtropical areas of socioeconomic disadvantage.

MAIN BODY

This systematic literature review identified studies published in the last ten years on the risk factors, diagnosis, prevalence and/or clinical outcomes of strongyloidiasis in Ethiopia. The prevalence of S. stercoralis ranged from 0.2 to 11.1% in adults, 0.3% to 20.7% in children, 1.5% to 17.3% in HIV positive adults and 5% in HIV positive children. The identified studies primarily used microscopy based techniques that potentially underestimated the prevalence four fold compared with serology and PCR. Strongyloidiasis in children presents a particularly significant issue in Ethiopia as children often presented with anemia, which is associated with impaired mental and cognitive development. The most significant risk factor for strongyloidiasis was HIV status and although other risk factors were identified for helminth infections, none were statistically significant for S. stercoralis specifically. Several studies detected S. stercoralis in dogs and non-biting cyclorrhaphan flies. However, future research is needed to explore the role of these reservoirs in disease transmission.

CONCLUSIONS

This review demonstrated that strongyloidiasis is an overlooked and neglected disease in Ethiopia. There is a need for a systematic approach using a combination of molecular and serology based diagnostic methods to ascertain the true incidence and burden of strongyloidiasis in Ethiopia. Further research is also needed to break the cycle of transmission by identifying environmental reservoirs, risk factors and exploring the potential for zoonotic transfer.

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.

Enteropathogens in Under-Five Children with Diarrhea in Health Facilities of Debre Berhan Town, North Shoa, Ethiopia

Background

Diarrheal disease is a major cause of mortality and morbidity for under-five children in Ethiopia. The purpose of this study was to investigate the behavioral and socioeconomic risk factors, etiology, and drug susceptibility of bacteria isolated from under-five children with acute diarrhea who were treated at Debre Berhan Referral Hospital or Health Center in Ethiopia.

Methods

A health facility based cross-sectional study design was used to investigate enteropathogens from 163 under-five children with acute diarrhea. After obtaining written consent from parents or guardians, data were collected using a standardized questionnaire. Freshly passed stool samples were collected for microbiological tests for bacteria and parasites. The chi-square test was used for assessing the relationships of variables.

Results

Enteropathogens were detected among 55.8% (91/163) participants. There was a 46%(75/163) bacterial culture positivity rate and a 9.8%(16/163) prevalence of parasites. The isolated enteropathogens were Escherchia coli, Klebsiella specie, Proteus species, Salmonella species, Shigella species, Enterobacter species, Giardia lamblia, Enteameba histolytica, Ascaris lumbricoides, Trichuris trichiura and Hymnoleps nana. Level of antimicrobial resistance of bacterial isolates ranged from 0 to 87.2%. Poor hand washing and poor cleaning of feeding utensils showed significant association with the presence of enteropathogens.

Conclusion

Bacterial enteropathogens with drug resistance were observed in this study. Continuous health education and promotion about diarrheal disease for mothers/caretakers and regular surveillance of entropathogenes are recommended to reduce under-five mortality.

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.

Prevalence and Associated Factors of Intestinal Parasitic Infections among Food Handlers at Prison, East and West Gojjam, Ethiopia

INTRODUCTION

One of the top ten major public health problems in developing countries including Ethiopia is the intestinal parasitic infection. Most of the time, intestinal parasitic infections do not show clinical signs and symptoms and also have a number of potential carriers, such as food handlers, which makes it too difficult to eradicate and control.

OBJECTIVE

The aim of this study is to assess the prevalence and associated factors of intestinal parasitic infection among food handlers at prison, East and West Gojjam, Ethiopia, 2017.

METHODS

An institution-based cross-sectional study design was conducted at East and West Gojjam prison. A total of 416 study participants, with a response rate of 82.7%, were included in the study for both stool exam and questioner. Data were collected using a structured questionnaire, and the sample was collected and examined based on the standard parasitological procedure. Epi data Version 3.1 was used to enter data, and SPSS version 20 was used to analyze the data.

RESULTS

The overall prevalence of intestinal parasitic infections in the present study was 61.9%. The most prevalent parasite was A. lumbricoides (157 (45.6%)). Protozoan infection was higher than helminth infection. Multiple intestinal infections were identified; among study participants, 34.6% had double infection. The most significant associated factors of intestinal parasitic infections were fingernail status, residence, information about food contamination related to intestinal parasitic infection, income, and handwashing before having contact with food and after toilet with water only.

CONCLUSIONS

A high proportion of intestinal parasitic infection was detected among food handlers working at East and West Gojjam prison. Training must be given to the food handlers on personal hygienic conditions (finger trimming, handwashing after toilet and before having contact with food with water and soap, etc.).

Prevalence of intestinal parasites in food handlers of the city of Saqqez in 2016

This study was aimed at determining the prevalence of parasitic infections among the food handlers of Saqqez County in 2016. Stool samples collected from 1530 food handlers. All samples were examined by both direct technique and sedimentation technique using formalin-ethyl acetate for detecting the intestinal parasites. Of total participants, 1462 (95.6%) were male and 62 (4.4%) female. Intestinal parasitic infections were found in 92 (6.01%) individuals. The highest infection rate was due to Giardia lamblia (4.1%) and the lowest associated with Endolimax nana, Iodamoeba butschlii, and Hymenolepis nana (0.1%). No significant correlation between the intestinal parasitic infections and age, gender, education level, gastrointestinal signs and symptoms, and the type of profession, was established. The results of the present study revealed that only a small number of food handlers in Saqqez County were infected with intestinal parasites with G. lamblia as the most common cause of infection. More strict health control for those working in food industries is of vital importance and continuous education to improve the level of general health in these people is undoubtedly considered as a key determinant towards lower number of parasitic infections.

Bacterial and Parasitic Assessment from Fingernails in Debre Markos, Northwest Ethiopia

BACKGROUND

Food handlers with untrimmed finger nails could contribute or serve as a vehicle for the transmission of food poisoning pathogens.

OBJECTIVES

This study was conducted to determine the prevalence of bacteria and intestinal parasites among food handlers and antibiotic susceptibility profile of the isolated bacteria in Debre Markos University, Ethiopia.

MATERIALS AND METHODS

This laboratory-based cross-sectional study involved 220 food handlers working in food service establishments in Debre Markos University between 1st January 2015 to 31th June 2016. Subjects' finger nail specimens of both hands were examined microscopically for intestinal parasites. For bacterial isolation, samples were cultured and bacterial species were identified following standard laboratory procedures. Antimicrobial susceptibility test was performed for all bacterial isolates by using Kirby-Bauer disk diffusion method.

RESULTS

Of the total 220 subjects examined, 29.5% showed positive culture for different bacterial species from their fingernail contents. Coagulase-negative Staphylococcus was the predominant bacteria species (12.3%) followed by Staphylococcus aureus (5%), E. coli (2.7%), Klebsiella species (2.7%), Enterococcus species (1.8%), Pseudomonas aeruginosa (1.8%), Proteus species (1.4%), Citrobacter species (1.4%), and Serratia species (0.9%). None of the food handlers showed positive culture for Shigella and salmonella and parasites in respect of their finger nail specimens. Isolation of bacteria in finger nail has significant association with finger nail status (P=0.044) and inverse relation with service years (P=0.048). All Staphylococcus aureus and coagulase-negative Staphylococcus species isolates were uniformly susceptible to vancomycin. Only one (9.1%) of Staphylococcus aureus isolates was resistant for methicillin.

CONCLUSION

To prevent the food poisoning pathogens, implementation and adherence to infection are the key practices, specially food handlers with long finger nail harbor food debris, microbial contaminations, and allergens.

Burden of intestinal pathogens and associated factors among asymptomatic food handlers in South Ethiopia: emphasis on salmonellosis

Objective

The study aims to assess the burden of intestinal parasites and Salmonellosis among asymptomatic food handlers at meal serving facilities in Sodo town. Antibiotic resistance was also common and increasing among Salmonella isolates with multidrug resistance as current concern.

Result

Community based cross-sectional study was carried out from 387 food handlers working in meal serving facilities. Food handlers, 159(41%) had one or more intestinal parasites. A. lumbricoides was the most prevalent parasite 30(7.8%), followed by Taenia species 26(6.7%) and Hook worm 23(5.9%). A total number of 35 Salmonella isolates were found of which Sero-group D was the most frequent, 17(48.5%) followed by Sero-group C, 12(34.3%), and B 6(17.1%). Ten (2.5%) isolates were Salmonella typhi. Raw meat eating, hand washing after toilet and after touching dirty materials showed significant association with intestinal pathogens. Salmonella isolates were highly resistant to ampicillin (85.7%), amoxicillin and tetracycline 74.3% each. Multidrug resistance prevalence of 81.8% was identified. Periodic screening of food handlers is important in order to prevent the transmission of intestinal parasites and Salmonellosis. Treatment needs to be based on accurate laboratory detection to mitigate the spread of drug resistant Salmonella strains.

Electronic supplementary material

The online version of this article (10.1186/s13104-018-3610-4) contains supplementary material, which is available to authorized users.

Prevalence of antibiotic resistant Escherichia coli isolates from fecal samples of food handlers in Qatar

Background

It is well documented that food handlers harbor and shed enteric foodborne pathogens causing foodborne disease outbreaks. However, little known on enteric antibiotic resistant (AR) bacteria carriage in food handlers. The objective of this study was to establish a baseline prevalence of fecal AR E. coli among food handlers in Qatar.

Methods

Fecal samples were collected from 456 migrant food handlers of different nationalities arriving in Qatar on a work permit between January 2015 and December 2016. These samples (25 g each) were collected based on the availability and examination schedule at the Medical Commission facility from those consented to participate. Isolated E. coli bacteria were tested for antibiotic susceptibility against nine antibiotics using the E-test method and Double Disc Synergy Test (DDST) for extended-spectrum beta-lactamase (ESBL) production.

Results

From the 78 E. coli positive samples (17.1%, n = 456), 60% of the isolates were resistant to at least one antibiotic, whereas, 27% were multi-drug resistant (MDR). Seven isolates (9%, n = 78) were ESBL producers of which five were MDR. Individual AR E. coli frequencies to the nine antibiotics were not significantly (P > 0.05) different by nationality.

Conclusions

Based on our findings, we revealed that individual resistant E. coli and MDR resistant E. coli were common in fecal samples of food handlers in Qatar. This may indicate that food handlers can potentially contaminate foods with AR E. coli, a possible public health concern.

Prevalence and antimicrobial susceptibility pattern of Salmonella and Shigella species among asymptomatic food handlers working in Haramaya University cafeterias, Eastern Ethiopia

Objective

Salmonellosis and Shigellosis remain a major public health problem across the globe, particularly in developing countries like Ethiopia, where hand hygiene and food microbiology are still below the required standards. The growing problem of antimicrobial resistance species also continues to pose public health challenges. This study assessed the prevalence and antimicrobial susceptibility pattern of Salmonella and Shigella species among asymptomatic food handlers. A cross-sectional study was conducted among 417 randomly selected asymptomatic food handlers. Data were collected using a structured questionnaire. The stool specimens collected were examined for Salmonella and Shigella species using standard bacteriological methods. Descriptive statistics were used to describe the basic features of the data.

Results

The overall prevalence of Salmonella and Shigella species was 5.04%. Salmonella and Shigella species were 76.2% resistant to both co-trimoxazole and tetracycline, 71.4% to amoxicillin and 66.7% to chloramphenicol. Moreover, 85.7% of Salmonella and Shigella species were multidrug resistant. The findings highlighted the food handlers as potential sources of food borne infections, which demands the establishment of appropriate hygiene and sanitary control measures at the University cafeterias.

Prevalence of Intestinal Parasites in Food Handlers of Bandar Abbas, Southern Iran

BACKGROUND

Food handlers play a significant role in the dissemination and transmission of enteropathogenic microorganisms, including intestinal parasites. The aim of this study was to determine the prevalence of intestinal parasites in food handlers of Bandar Abbas, southern Iran.

METHODS

In this cross-sectional study, 800 stool samples were randomly collected in a period of 6 months from Jun to Nov 2015. The diagnosis was made on direct wet mount, formalin-ether concentration, Ziehl-Neelsen, and Trichrome stained slides.

RESULTS

34.9% of participants were positive for stool parasites. The most infected individuals were seen in the workers of bakeries 54.3%, factories 41.1% fast foods 35.7%, supermarkets 34.7%, restaurants 33.9%, offices 29.8%, butchers 27.3% and coffee shops 26.7% respectively (P<0.05). The intestinal parasites were Blastocystis hominis 24.3%, Entamoeba coli 8%, Giardia lamblia 6.8% and Dientamoeba fragilis 4.3% respectively. Only two infections by Hymenolepis nana (0.3%) and one by Enterobius vermicularis (0.1%) were detected in this study. Living in the workplace and direct contact with the raw foodstuff affected the prevalence of intestinal parasites (P<0.05).

CONCLUSION

The use of concentration methods for the detection of intestinal parasites as well as continuous and effective education in short-term courses to promote hygienic behavior is suggested.

Intestinal parasitic infections among expatriate workers in various occupations in Sharjah, United Arab Emirates

Intestinal parasitic infections are prevalent throughout many countries. This study aimed to determine the prevalence of intestinal parasite carriers among 21,347 expatriate workers, including food handlers and housemaids attending the public health center laboratory in Sharjah, UAE. Stool sample collection was performed throughout the period between January and December 2013. All samples were examined microscopically. Demographic data were also obtained and analyzed. Intestinal parasites were found in 3.3% (708/21,347) of the studied samples (single and multiple infections). Among positive samples, six hundred and eighty-three samples (96.5%) were positive for a single parasite: Giardia lamblia (257; 36.3%) and Entamoeba histolytica/Entamoeba dispar (220; 31.1%), respectively, whereas mono-infections with helminths accounted for 206 (29.1%) of the samples. Infection rates with single worms were: Ascaris lumbricoides (84; 11.9%), Hookworm (34; 4.8%), Trichuris trichiura (33; 4.7%), Taenia spp. (27; 3.81%), Strongyloides stercoralis (13; 1.8%), Hymenolepis nana (13; 1.8%), and Enterobius vermicularis (2; 0.28%), respectively. Infections were significantly associated with gender (x² = 14.18; p = 0.002) with males as the most commonly infected with both groups of intestinal parasites (protozoa and helminths). A strong statistical association was noted correlating the parasite occurrence with certain nationalities (x²= 49.5, p <0.001). Furthermore, the study has also found a strong statistical correlation between parasite occurrence and occupation (x²= 15.60; p = 0.029). Multiple infections were not common (3.5% of the positive samples), although one individual (0.14%) had four helminth species, concurrently. These findings emphasized that food handlers with different pathogenic parasitic organisms may pose a significant health risk to the public.

Detection and identification of antimicrobial-resistant Salmonella in raw beef at Wolaita Sodo municipal abattoir, Southern Ethiopia

BACKGROUND

The consumption of multidrug resistant Salmonella isolates along with a raw meat dish is directly relevant to the global public health crisis of antimicrobial resistance. All countries around the globe are suffering from food-borne diseases. In developing countries, more than one billion individuals suffering from gastroenteritis and around five million infected individuals die annually.

METHODS

A cross-sectional study was carried out from December 2015 to May 2016 to show the risk of Salmonella associated with consuming traditional raw meat dishes and to characterize the antimicrobial resistance profile at Wolaita Sodo municipal abattoir. Animals were being processed as part of the normal work of the abattoir, and 448 carcass samples were taken after getting a written consent from the municipality. Samples were transported to Wolaita Sodo University Microbiology Laboratory in an ice box within an hour of collection. Swab samples were pre-enriched in tetrathionate broth and Rappaport-Vassiliadis R10 broth. Broth culture was sub-cultured on xylose lysine deoxycholate and brilliant green agar and incubated at a temperature of 37 °C for overnight. Antimicrobial susceptibility test was done by disk diffusion method. Microbiological and observational data entry and analysis were done using Microsoft Excel 2007.

RESULTS

From the total 448 sampled carcasses, Salmonella growth was observed in 56 (12.5%) samples. The isolates had various resistance profiles, with resistance to 1 to 12 antimicrobial drugs. Tetracycline- and nitrofurantion-resistant isolates were frequent, 83.93 and 73.21% respectively, and followed by streptomycin-resistant isolates (66%). Ciprofloxacin-resistant isolates were rare (7%).

CONCLUSION

Salmonella species contamination frequency was high in raw beef, and most of the isolates exhibited resistance to commonly used antibiotics. People living in the town and consuming the raw meat are at risk for developing diseases, and attention should be given to select antimicrobials in treating Salmonella infections in both animals and human being based on antimicrobial susceptibility test. Moreover, intersectoral working and developing one health approach is essential. Health information should be given to individuals who have the habit of eating raw meat. Training on sanitary and hygiene practice should be given to the abattoir workers.