Antimicrobial resistance (AMR) is increasingly becoming a threat to global public health, not least in low- and middle-income countries (LMICs) where it is contributing to longer treatment for illnesses, use of higher generation drugs, more expenditure on antimicrobials, and increased deaths attributed to what should be treatable diseases. Some of the known causes of AMR include misuse and overuse of antimicrobials in both humans and animals, unnecessary use of antimicrobials in animals as growth promoters, and lack of awareness among the public on how to protect antimicrobials. As a result, resistant organisms are circulating in the wider environment, and there is a need to consider the One Health approach to minimise the continuing development of AMR. Environmental Health, specifically water, sanitation and hygiene (WASH), waste management, and food hygiene and safety, are key components of One Health needed to prevent the spread of antimicrobial-resistant microorganisms particularly in LMICs and reduce the AMR threat to global public health. The key Environmental Health practices in the prevention of AMR include: (1) adequate WASH through access and consumption of safe water; suitable containment, treatment and disposal of human excreta and other wastewater including from health facilities; good personal hygiene practices such as washing hands with soap at critical times to prevent the spread of resistant microorganisms, and contraction of illnesses which may require antimicrobial treatment; (2) proper disposal of solid waste, including the disposal of unused and expired antimicrobials to prevent their unnecessary exposure to microorganisms in the environment; and (3) ensuring proper food hygiene and safety practices, such as sale and consumption of animal products in which adequate antimicrobial withdrawal periods have been observed, and growing vegetables on unpolluted soil. Environmental Health is therefore crucial in the prevention of infectious diseases that would require antimicrobials, reducing the spread of resistant organisms, and exposure to antimicrobial residues in LMICs. Working with other professionals in One Health, Environmental Health Practitioners have a key role in reducing the spread of AMR including health education and promotion, surveillance, enforcement of legislation, and research.
Developing Countries ; Disease Transmission, Infectious/prevention & control* ; Drug Resistance, Microbial ; Environmental Health/standards* ; Food Safety ; Health Personnel/standards* ; Humans ; Hygiene/standards* ; Role ; Sanitation/standards* ; Waste Management/standards*

BACKGROUND: Food safety and hygiene are currently a global health apprehension especially in unindustrialized countries as a result of increasing food-borne diseases (FBDs) and accompanying deaths. This study aimed at assessing knowledge, attitude, and hygiene practices (KAP) of food safety among street-cooked food handlers (SCFHs) in North Dayi District, Ghana. METHODS: This was a descriptive cross-sectional study conducted on 407 SCFHs in North Dayi District, Ghana. The World Health Organization's Five Keys to Safer Food for food handlers and a pretested structured questionnaire were adapted for data collection among stationary SCFHs along principal streets. Significant parameters such as educational status, average monthly income, registered SCFHs, and food safety training course were used in bivariate and multivariate logistic regression models to calculate the power of the relationships observed. RESULTS: The majority 84.3% of SCFHs were female and 56.0% had not attended a food safety training course. This study showed that 67.3%, 58.2%, and 62.9% of SCFHs had good levels of KAP of food safety, respectively. About 87.2% showed a good attitude of separating uncooked and prepared meal before storage. Good knowledge of food safety was 2 times higher among registered SCFHs compared to unregistered [cOR=1.64, p=0.032]. SCFHs with secondary education were 4 times good at hygiene practices of food safety likened to no education [aOR=4.06, p=0.003]. Above GHc1500 average monthly income earners were 5 times good at hygiene practices of food safety compared to below GHc500 [aOR=4.89, p=0.006]. Registered SCFHs were 8 times good at hygiene practice of food safety compared to unregistered [aOR=7.50, p<0.001]. The odd for good hygiene practice of food safety was 6 times found among SCFHs who had training on food safety courses likened to those who had not [aOR=5.97, p<0.001]. CONCLUSIONS Over half of the SCFHs had good levels of KAP of food safety. Registering as SCFH was significantly associated with good knowledge and hygiene practices of food safety. Therefore, our results may present an imperative foundation for design to increase food safety and hygiene practice in the district, region, and beyond.
Adult ; Attitude ; Cooking/methods* ; Cross-Sectional Studies ; Female ; Food Safety ; Ghana ; Health Knowledge, Attitudes, Practice ; Humans ; Hygiene ; Male ; Middle Aged ; Socioeconomic Factors ; Young Adult

The purpose of this study was to investigate the status of school nutrition education and changes in perception of nutrition teacher's job in order to determine the need for redesign to achieve their ideal job. The questionnaire was distributed to 1,550 nutrition teachers, and a total of 1,487 usable data were collected with a 96% response rate from August to December 2015. Statistical data analysis was completed by using SPSS/Win 21.0 for descriptive analysis. The results were as follows: 45.5% of nutrition teachers periodically implemented nutrition education classes, and 32.7% of responses used creative activity times for nutrition and dietary life education. Various topics were taught such as strategies to improve dietary habits, choice of healthy foods and nutrition labeling, nutrition information, food safety, and environmental problems, etc. Current performance ratios of nutrition teacher's duties and tasks were as follows: nutrition operation 31.3%, foodservice hygiene and safety 28.0%, nutrition management 22.7%, nutrition and dietary life education and counselling 11.6%, and professional development 6.4%. Opinions about ideal job performance of nutrition teachers were investigated to determine needs for job redesign. Two in nutrition management duty tasks and four foodservice management duties duty tasks were reduced. On the other hand, another two nutrition management duty tasks and three nutrition and dietary life education and counselling tasks were increased compared to current job performance.
Data Interpretation, Statistical ; Education ; Food Habits ; Food Labeling ; Food Safety ; Hand ; Humans ; Hygiene ; Work Performance

OBJECTIVES: Adulterated food education in adolescence period is very important because dietary management related to food safety is not made in a short period. This study aimed to identify dietary lifestyle factors which drive adulterated food management among middle and high school students. METHODS: Data was collected from 270 middle and high school students in Daegu using a self-administered questionnaire in March and April of 2015. Data was analyzed using frequency analysis, one-way analysis of variance, χ²-test, factor analysis, reliability analysis, regression analysis, and cluster analysis. RESULTS: The results of factor analysis indicated that adulterated food management awareness was classified into necessity, difficulty, and food purchasing anxiety. The adulterated food management capability was sub-grouped into environmental grasp, food identification, cooking hygiene, and situation management. The adulterated food management efficacy composed of management confidence, action intention, and knowledge. Dietary lifestyle comprised of gustation, family, and health factors after factor analysis, and it consisted of all seeking group, gustation seeking group, family seeking group, health seeking group, and family and health seeking group after cluster analysis. The gustation, family and health factors were significantly affected the factors of awareness, capability and efficacy of adulterated food management (p < 0.05). The frequency of health conditions, helping with meal preparation, and the times of eating out were significantly different according to seeking groups of dietary lifestyle (p < 0.01). The scores of awareness, capability and efficacy of adulterated food management of family and health seeking group were significantly higher than the other seeking groups (p < 0.05). CONCLUSIONS: This study suggests that adulterated food management education programs should account for gustation, family and health factors of dietary lifestyle to be effective for adolescents.
Adolescent* ; Anxiety ; Cooking ; Daegu ; Eating ; Education ; Food Safety ; Hand Strength ; Humans ; Hygiene ; Intention ; Life Style* ; Meals

The purpose of this current study was to examine the effects of nutrition and food safety management support by the Center for Children's Foodservice Management (CCFSM) in foodservice facilities for children in the Ulsan area. From December 2014 to July 2015, the status of nutrition practices and hygiene practices was assessed by dietitians using nutrition and hygiene practice checklists. The subjects of study were 48 institutional foodservice facilities for children. Some nutrition practice items showed significant increases in average scores of 'using CCFSM menus (P<0.001), revising menus (P<0.05), and reconfirm menus (P<0.01)' from pre-support to post-support. Regarding hygiene practices, some items between pre-support to post-support showed significant increases in average scores of 'having equipment for hand washing & disinfecting' (P<0.01), 'wearing disinfected clothing for kitchen hygienically' (P<0.05), 'proper sterilization' (P<0.05), 'recording the origin of ingredients' (P<0.01), 'use of different knives/cutting boards' (P<0.05), and 'an appropriate thawing process' (P<0.05) from pre-support to post-support. Based on the above results, we found that nutrition and hygiene management support by CCFSM in foodservice facilities for children had a positive influence on status of some nutrition and food safety practices.
Checklist ; Child ; Clothing ; Education* ; Food Safety ; Hand Disinfection ; Humans ; Hygiene* ; Nutritionists ; Ulsan*

The purpose of this study was to assess the hygiene status of 145 child-care foodservices, which were newly registered in the Center for the Children's Foodservice Management (CCFSM) in Changwon, Gyeongnam. Sanitary inspection checklist (40 food safety items) of Korea Food and Drug Administration (KFDA) was used by the CCFSM in Changwon, Gyeongnam. Average score from the total safety items in 145 child-care foodservices was 21.41 points out of 40 points. Score gaps between the lower group (71 foodservices, 13.92 points) and higher group (74 foodservices, 28.61 points) showed a significant difference (P<0.001). The top five priorities of sanitary measures needing corrective actions for child-care foodservices were as follows: 'provide hand washing and sanitizing tools, and supply manuals on how to wash hands properly', 'supply record form for access/inspection', 'conduct education for cooks on standards in the selection of sanitizer for raw vegetables and proper methods to wash and sanitize raw vegetables', 'provide a refrigerator and a freezer with installed thermometers and temperature record monitoring logs', 'encourage separation of contamination operating zone and clean zone or conduct training for cooks on ways to prevent cross-contamination by performing work separately by the hour'. For the higher group, most were national/public facilities (83.3%), whereas in the lower group, private facilities (62.1%) were more common than national/public ones (37.9%). Therefore, a significant difference (P<0.001) was detected in the two groups. These private facilities should be supported.
Checklist* ; Education ; Food Safety ; Gyeongsangnam-do ; Hand ; Hand Disinfection ; Hygiene ; Korea* ; Thermometers ; United States Food and Drug Administration* ; Vegetables

OBJECTIVETo assess the food safety knowledge and practices in meat handling, and to determine microbial load and pathogenic organisms in meat at Mekelle city.

METHODSA descriptive survey design was used to answer questions concerning the current status of food hygiene and sanitation practiced in the abattoir and butcher shops. Workers from the abattoir and butcher shops were interviewed through a structured questionnaire to assess their food safety knowledge. Bacterial load was assessed by serial dilution method and the major bacterial pathogens were isolated by using standard procedures.

RESULTS15.4% of the abattoir workers had no health certificate and there was no hot water, sterilizer and cooling facility in the abattoir. 11.3% of the butchers didn't use protective clothes. There was a food safety knowledge gap within the abattoir and butcher shop workers. The mean values of bacterial load of abattoir meat, butcher shops and street meat sale was found to be 1.1×10(5), 5.6×10(5) and 4.3×10(6) cfu/g, respectively. The major bacterial pathogens isolated were Escherichia coli, Staphylococcus aureus and Bacillus cereus.

CONCLUSIONSThe study revealed that there is a reasonable gap on food safety knowledge by abattoir and butcher shop workers. The microbial profile was also higher compared to standards set by World Health Organization. Due attention should be given by the government to improve the food safety knowledge and the quality standard of meat sold in the city.

Abattoirs ; standards ; Colony Count, Microbial ; Ethiopia ; Food Microbiology ; Food Safety ; Health Knowledge, Attitudes, Practice ; Health Surveys ; Humans ; Hygiene ; Meat ; microbiology ; Surveys and Questionnaires

Influx of foreign students in Malaysia calls for a study on safety of food in Malaysia restaurants as perceived by them. This study aims to investigate perception of foreign students regarding food safety and personal hygiene practice of food handlers in Malaysia restaurants. A six sections Likert scale questionnaire was used. A total of 350 questionnaires were distributed during this study between March 2011 and March 2012 to the international students from 26 countries of the world in various public and private institutions of higher learning in Klang Valley, Malaysia. Among the distributed questionnaires, only 155 were correctly filled, retrieved and analyzed. Ninety-one respondents (59%) were male while 63 (41%) were females. A total of 107 (69%) were undergraduates and 29 (19%) were postgraduate students. One hundred and thirty-nine (90%) respondents were local or foreign restaurants. Eleven respondents (7%) did not patronize any of the restaurants. Among factors influencing choice of restaurants are closeness to residence, price of food and quality of food were the most important factors 62 (38%). Twenty-seven (28%) eat in restaurants because of the similarity of the food to that of their home country. Of the most preferred food, Nasi ayam, 89 (57%) top the list, next was Nasi goreng ayam, 14 (14%) and African food, 23 (15%). Nasi lemak was the least food preferred 3 (2%). A total of 104 (67%) respondents were of the opinion that handlers kept short nails, 91 (59%) do not pick nose, 108 (55%) stated that food handlers cough or sneeze while handling food. Ninety-eight respondents (64%) also stated that serving of food with unprotected hands were observed. The result of this study showed that although food handlers are aware of the need for personal hygiene, more awareness needs to be created.
Food Safety ; Foodborne Diseases ; Students ; Emigrants and Immigrants ; Hygiene ; Restaurants ; Malaysia

The hand hygiene behavior of 400 middle school students (grades 1-3) in Seoul and Gyeonggi-Do was studied to determine how stages of change were affected by food safety education, focusing on hand hygiene and general food safety. Subjects were 51.3% male and 44.3% of study subjects were first graders of middle school. Approximately 40% of subjects were at the stage of action, 42.7% were at the stage of contemplation, and 16.4% were at pre-contemplation. The most important factor that influenced proper hand washing was self efficacy (P < 0.001). Proper hand washing was also correlated significantly with positive belief (P < 0.01) and stages of change (P < 0.01). After food safety education by high-school mentors, middle-school students who were in the stages of pre-contemplation (11.1%) and contemplation (88.9%) showed significant progression toward the action stage (P < 0.001). Proper hand washing (P < 0.01) and food safety knowledge (P < 0.05) were also significantly increased after educational intervention.
Food Safety ; Hand ; Hand Disinfection ; Hand Hygiene ; Humans ; Male ; Mentors ; Self Efficacy

This study examined the current status of foodservice management in elderly welfare facilities and evaluated food service workers' food safety practices and knowledge. For this, the directors of 20 elderly welfare facilities (each with fewer than 50 residents) located in Seoul were interviewed and a survey of 40 foodservice workers was conducted to determine their food safety knowledge and practices. The facilities accommodated an average of 28 residents. All the facilities were self-operated and approximately 62% were dependent on payments by residents. Only 15% had a dietitian in charge of menu planning, food purchasing, and food safety management. Approximately 50% had their facility managers take responsibilities for menu planning and food safety management. Most of the facilities provided food safety training within their own facility and sanitized their utensils, cutting boards, and dishcloths on a daily basis. A limited number of foodservice workers, insufficient training programs, and budget constraints were some of the major barriers to food safety management. Their average score on food safety practices was 1.62, and that on food safety knowledge was 17.6 out of 19 points. These results indicate that the foodservice workers had good food safety knowledge and appropriate food safety practices. There was a significant correlation only between food safety practices related to receiving and storing food products and knowledge of personal hygiene.
Aged ; Budgets ; Fees and Charges ; Food Safety ; Food Services ; Humans ; Hygiene ; Menu Planning