Knowledge, Attitude And Practice Of Food Hygiene And Safety Among Street Food Handlers In Jalingo Metropolis
This study was carried out on the knowledge, attitude and practice of food hygiene and safety among street food handlers in Jalingo metropolis. A cross-sectional descriptive study design was employed in this study. The total population was taken as the sample size, in view of the fact that the population size is known. Therefore, all the 191 food handlers in Jalingo metropolis were studied. Prior to administration of questionnaire, three research assistants were trained on the appropriate skills needed for interviewing respondents. These assistants were staff of the Environmental Sanitation unit of Area Health Services, Jalingo metropolis. The data was cleaned and analyzed using Statistical Package for Social Sciences (SPSS) version 15. The result of the study showed that the level of knowledge of food hygiene amongst the food handlers was high giving the fact that almost all the food handlers had never had any formal training on food safety. Also, Food handlers’ attitude towards hygiene practice was equally good. Lastly, level of hygiene practice among the food handlers was however not encouraging with majority of them only having fair practice. The study concluded that the knowledge and attitude about food hygiene amongst the food handlers was good. However, the practice of food hygiene was only fair. The study recommended that any prospective food handler seeking to operate an eatery in Jalingo metropolis should be compulsorily made to have pre-employment examination to assess his/her level of knowledge of food hygiene by the sanitary health officer(s) of the environmental health unit in conjunction with the medical officer(s) of the Area Health Services Department.
1.1 Background of the study
Food hygiene practices is a subject of wide scope and it is a broad term used to describe the preservation and preparation of foods in a manner that ensures the food is safe for human consumption.1 Food hygiene deals with the prevention of contamination of food stuffs at all stages of production, collection, transportation, storage, preparation, sale and consumption. Food borne illness is defined as a disease, usually either infectious or toxic in nature, caused by agents that enter the body through the ingestion of food.2 This process of kitchen safety includes proper storage of food items prior to use, maintaining a clean environment when preparing the food, and making sure that all serving dishes are clean and free of bacteria that could lead to some type of contamination. The food storage aspect of food hygiene is focused on maintaining the quality of the food, so that it will be fresh when used in different recipes. Food safety is a scientific discipline describing handling, preparation, and storage of food in ways that prevent foodborne illnesses.3 This include the number of routines that should be followed to avoid potentially severe health hazards. Food can transmit diseases from one person to the other as well as serve as a growth medium for bacteria that can cause food poisoning.
Debates on genetic food safety include such issues as impact of genetically modified food on health of further generations and genetic pollution of environment, which can destroy natural biological diversity. In developed countries, there are intricate standards for food preparation, whereas in lesser developed countries, the main issue is simply the availability of adequate safewater, which is usually a criticalitem. In theory, food poisoning is hundred percent (100%) preventable.3 Food sanitation also extends to keeping the preparation area clean and relatively germ-free. Mixing bowls, spoons, paring knives and any other tools used in the
kitchen should be washed thoroughly before use. Kitchen countertops and cutting boards should also be cleaned and sterilized from time to time. Keeping a sanitary workplace will also cut down on the chances of some type of foodborne illnesses from developing when people consume a prepared food.
Food contamination occurs most commonly from excreta on people’s fingers, flies etc (i.e.faeco-oral transmission). Food contamination may also occur by skin infection especially the hands of food-vendors (staphylococcal food poisoning), consumption of diseased animals (tape worm, brucellosis etc) or chemicals used as pesticides on crops.
Every person is at risk of foodborne illness. It is a widespread and growing public health problem both in developed and developing countries; the effect being more devastating in developing countries.2 Consumers have a reasonable expectation that the foods they purchase have been produced and processed under hygienic condition and that the food has not been adulterated by addition of any biological, chemical, or physical hazard. These expectations are regularly enforced by regulations that govern production, processing, distribution and retailing of foods and drugs in any country. In Nigeria for example, this task is performed by National Agency for Food Drug Administration and Control(NAFDAC).
So much emphasis is placed on food safety that necessitated the World Health Organization (WHO) formulating a general principle2 of food hygiene which basically are:
- Prevent contaminating food with pathogens spreading from people, pets and pests.
- Separate raw from cooked foods to prevent contaminating the cooked food.
- Cook food for the appropriate length of time and at the appropriate temperature to kill pathogens.
- Store food at the proper temperature.
- Use safe water and raw materials.
1.2 Problem Statement
Food, being the most important and only substance that is universally consumed by all humans and animals to stay alive, need to be handled or safe guarded properly because contamination anywhere along the food chain can have far reaching effects and sometimes fatal consequences. Food borne illnesses is a burden in terms of incapacitating people, causing discomfort, cost of pain, grief and suffering, disruption to industry and commerce and strain on the healthservice.5
On 11th of August 2010, the Minister of Health of the Caribbean stated that during the years 2000-2005, over 55 outbreaks of food and water borne illnesses involving over 26,000 guests and staff from 14 Caribbean island countries were reported to the Caribbean Epidemiology Centre.
The global incidence of foodborne disease is difficult to estimate, but it has been reported that in 2005 alone, 1.8 million people died from diarrhoeal diseases.2 A great proportion of these cases can be attributed to contamination of food and drinking water. Diarrhoea is a major cause of malnutrition in infants and young children. About 30% of populations of industrialized countries suffer from foodborne disease yearly.2
Globally, food contamination creates an enormous social and economic burden on communities and their health systems. In USA, diseases caused by major food pathogens are estimated to cost up to 35 billion US Dollar annually in medical cost and lost productivity. The re-emergence of cholera in Peru in 1991 resulted in the loss of 500 million US Dollars in fish and fishery product export that year.2
A 2003 WHO report concluded that about 40% of reported food poisoning outbreaks in WHO European region occur in private homes.2 According to the WHO and Centre for Disease Control (CDC), in the USA alone annually there are 76 million cases of foodborne illnesses leading to 325,000 hospitalization and 5,000 deaths.2In 1994, an outbreak of Salmonella food poisoning due to contaminated ice cream occurred in the USA affecting an estimated 224,000 persons.2In 1988, an outbreak of Hepatitis A, resulting from the consumption of contaminated clams, affected some 300,000 individuals in China. While less well documented, developing countries bear the brunt of the problem due to the presence of a wide range of foodborne diseases, including those caused by parasites. The high prevalence of diarrhoeal disease in many developing countries suggests major underlying food safety problems.2In Nigeria, it was stated in 2008 that over 20,000 Nigerians die annually and over 3 million cases of acute food poisoning are recorded yearly due to exposure of food to pesticides that are wrongly used byfarmers.6
1.3 Aim and Objectives
The general aim of this research is to determine the knowledge, attitude and practice of food hygiene and safety among street food handlers in Jalingo metropolis, Taraba state, Nigeria.
The specific objectives are:
- To assess the level of knowledge of food hygiene among the food handlers in Jalingo metropolis;
- To assess the attitude of food handlers towards food hygiene;
- To assess the practice of food hygiene the food handlers adopt while running their business;
- To investigate the type of medical examination that is being done before a new food handler is taken and periodic examination being done;
- To screen the food handlers for asymptomatic carriers of Salmonella specie(s); important pathogen(s) that could cause food poisoning.
Food hygiene is a business of serious concern not only to developing countries but also to developed countries because the ill-effect of contaminated food, when ingested, may be so devastating. In the event of an outbreak of food borne illness, not only do humans suffer, the economy, useful manpower, the health facilities etc are all strained; this is evidenced from the few examples above whereby huge amount of wealth is being sunk in managing food poisoning.
A survey to find out the food safety knowledge of street food handlers in Abeokuta, Ogun state was carried out involving 87 vendors.7 Only 12% had formal knowledge on food preparation; 31% had annual medical health certificate. Most of them only consider volume and price rather than freshness and cleanliness when buying raw materials for cooking. Some of the food safety knowledge cannot be translated to practice due to the absence of basic facilities such as water and toilets at their vendingsites.7
Food poisoning killed ten (10) secondary school teachers and hospitalized several others in the northern Nigeria town of Katsina on June 1st, 2011. The teachers became ill shortly after eating lunch during a weekend workshop for some six hundred and fifty (650) teachers organized by the state Ministry of Education, reported the Nigerian Tribune on Wednesday, 1st of June, 2011.8
In Nigeria, food and water borne diarrheal disease does occur in epidemic proportion, resulting in large number of avoidable deaths. An institution like Jalingo metropolis can‟t afford to be caught napping as far as food hygiene is concerned looking at its position in the committee of tertiary institutions. She has a huge responsibility in keeping both her students and staff safe from the adverse consequences of food poisoning. There has not been proper documentation of cases of food borne diseases in Jalingo metropolis, in the last few years. For the reasons noted earlier on, a study into food handlers’ hygiene practices seems highly justifiable.
1.5 Definition Of Terms
The removal of soil, food residue, dirt, grease or other objectionable matters from surfaces of plates, spoons, cutleries, utensils etc.
Any biological or chemical agent, foreign matter, or other substances not intentionally added to food which may compromise food safety or suitability.
The introduction or occurrence of a contaminant in food or food environment.
The reduction, by means of chemical agents and/or physical methods, of the number of micro-organisms in the environment, to a level that does not compromise food safety or suitability.
Any building or area in which food is handled and the surroundings under the control of the same management.
All conditions and measures necessary to ensure the safety and suitability of food at all stages of the food chain.
A biological, chemical or physical agent in, or condition of, food with the potential to cause an adverse health effect.
HACCP (Hazard Analysis and Critical Control Point)
A system that identifies, evaluates, and controls hazards which are significant for food safety.
Any person who directly handles packaged or unpackaged food, food equipment and utensils, or food contact surfaces and is therefore expected to comply with food hygiene requirements.
Assurance that food will not cause harm to the consumer when it is prepared and/or eaten according to its intended use.
Assurance that food is acceptable for human consumption according to its intended use.
Those steps in the food chain up to and including harvesting, slaughtering, milking, fishing etc.
Any permanent or semi permanent facility that stores, prepares or handles food.
Is an illness affecting our digestive system that result from eating food or drinking water contaminated by bacteria, bacterial toxins, or less commonly by residues of insecticides (on fruits and vegetables), or poisonous chemical such as lead, mercury, etc. it can also be caused by ingestion of fungi, berries, etc. that irritates the digestivesystem.4
Summary, Conclusion and Recommendation
From this study carried out to assess the knowledge, attitude and practice of food hygiene and safety among street food handlers in Jalingo metropolis, the following inferences can be drawn:
- The level of knowledge of food hygiene amongst the food handlers was high giving the fact that almost all the food handlers had never had any formal training on food safety. Again though, questions on which knowledge was tested were by no means exhaustive;
- Food handlers’ attitude towards hygiene practice was equally good. Again the scope of questions covered in assessing this could have been broadened to allow for better judgment of attitude;
- Level of hygiene practice among the food handlers was however not encouraging with majority of them only having fair practice. A few of them still had hygiene practices that could be considered poor. Observation from the checklist analysis revealed that most of the restaurants had acceptable score with regards the practice of food hygiene;
- Pre-employment medical examination normally done to screen individuals for eligibility to run eateries in Jalingo metropolis was not accorded the importance that it deserved. However, on-the-job medical examination was given a little more attention though the frequency of such examination was lower than expected which should be, at least once every year;
- Occurrence of two cases of chronic carrier of Salmonella, typhimurium and a case of carrier of Escherichia, coli in the gastro-intestinal tract are important findings as both organisms have the potential of causing food poisoning.
The knowledge and attitude about food hygiene amongst the food handlers was good. However, the practice of food hygiene was only fair. Medical examination of the food handlers was not satisfactory and stool examination revealed few parasites and two organisms capable of causing food poisoning. Direct observation of hygiene practices amongst these vendors in the restaurants revealed that only about one third of the food handlers readily washed hands in the course of food handling.
Based on the findings from this study, the following recommendations are proffered:
- Any prospective food handler seeking to operate an eatery in Jalingo metropolis should be compulsorily made to have pre-employment examination to assess his/her level of knowledge of food hygiene by the sanitary health officer(s) of the environmental health unit in conjunction with the medical officer(s) of the Area Health Services Department. This would enable the Health Department screen out those who might pose some threat to the area community as far as food safety is concerned.
- After the individual has successfully scaled through the pre-employment examination, he/she should undergo a comprehensive medical examination, which the medical officer(s) of the area health services department should request and perform, to confirm or refuteeligibilitytorunsuchabusiness.Whatisbeingdonepresentlyisnotreally encouraging as some food handlers get to undergo only periodic medical examination and not pre-employment medical examination.
- The area’s rules and regulations concerning choice of site for restaurant, the requirements of the structure, standard hygiene practice etc should always be enforced by the health team of the environmental health unit of Area Health Department through regular visitations to the restaurants and sanctioning of offenders to serve as deterrent.
- Regular and periodic medical examinations, by the medical officers, for the food handlers should be a norm rather than the present unscheduled and infrequent examination being done. Also, the periodic inspection, by the area health team, of the various eateries should be improved upon. This should also include a check on the source(s) of water the restaurant uses for domestic activities and for drinking coupled with periodic microbial testing of prepared foods, fish, meat, vegetables/fruits and drinking water which the microbiologist would undertake;
- There should be good communication system whereby the health team or the body charged with the responsibilities of managing all the eateries should be informed on time whenever a new food handler is to be employed by the manager/manageress of any eatery;
- Periodic food safety training sessions should be organized by the Area Health Department for the vendors in order to bring them abreast with global best practices and current trend in food handling business. This can be done by bringing in experts who could use audio-visual aids and/or practical demonstration of proper food handling to pass home their messages.
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