What Virus Is Spread By Food-service Workers' Poor Personal Hygiene?
BMC Public Health. 2017; 17: 40.
Food safe noesis, attitudes and practices of institutional food-handlers in Ghana
Fortune Akabanda
Section of Practical Biology, Faculty of Applied Sciences, University for Development Studies, P. O. Box 24, Navrongo Campus, Ghana
Eli Promise Hlortsi
Department of Applied Biology, Faculty of Practical Sciences, Academy for Development Studies, P. O. Box 24, Navrongo Campus, Ghana
James Owusu-Kwarteng
Department of Applied Biology, Faculty of Applied Sciences, University for Development Studies, P. O. Box 24, Navrongo Campus, Ghana
Received 2016 Jun 18; Accepted 2016 Dec 22.
- Data Availability Argument
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The authors declare that the data supporting the findings of this report are fully described within the manuscript.
Abstract
Background
In large calibration cooking, food is handled past many individuals, thereby increasing the chances of food contamination due to improper handling. Deliberate or accidental contamination of food during large scale product might endanger the health of consumers, and have very expensive repercussions on a land. The purpose of this report was to evaluate the nutrient safety knowledge, attitudes, and practices among institutional food- handlers in Ghana.
Methods
The report was conducted using a descriptive, cantankerous-exclusive survey of 29 institutions by conducting face up to confront interview and assistants of questionnaire to two hundred and 30-five (235) institutional food-handlers. The questionnaire was peer-reviewed and pilot tested in iii institutions in the Upper East Region of Ghana, before the final version was distributed to food-handlers. The questionnaire was structured into 5 distinctive parts to collect information on (i) demographic characteristics, (ii) employees' work satisfaction, (iii) knowledge on food safety, (iv) attitudes towards food prophylactic and (v) food hygiene practices.
Results
Majority of the nutrient-handlers were between 41–50 years (39.i%). Female respondents were (76.6%). In our study, the food-handlers were knowledgeable almost hygienic practices, cleaning and sanitation procedures. Almost all of the food-handlers were enlightened of the disquisitional role of general germ-free practices in the work place, such as mitt washing (98.7% correct answers), using gloves (77.ix%), proper cleaning of the instruments/utensils (86.4%) and detergent apply (72.eight%). On disease manual, the results indicates that 76.2% of the food- handlers did not know that Salmonella is a food borne pathogens and 70.six% did not know that hepatitis A is a food borne pathogen. However, 81.seven% handlers agreed that typhoid fever is transmitted by nutrient and 87.seven% agreed that bloody diarrhea is transmitted by food. Logistic regression assay testing iv models showed statistically significant differences (p < 0.05), for models in which the explanatory variable was the level of education.
Conclusions
In by and large, the institutional food-handlers have satisfactory knowledge in nutrient safety but this does not translate into strict hygienic practices during processing and treatment food products.
Keywords: Food-handlers, Nutrient condom, Ghana, Hygienic practices
Background
When nutrient is cooked on a big scale, it may be handled by many individuals and thus increasing the chances of contamination of the final food. Unintended contamination of nutrient during large scale cooking, leading to food-borne disease outbreaks can pose danger to the wellness of consumers and economic event for nations [ane–iii].
Food-borne related illnesses accept increased over the years, and negatively affected the health and economical well-being of many developing nations [4]. The World Health System (WHO) states that virtually one.8 million persons died from diarrheal diseases in 2005, mainly due to the ingestion of contaminated nutrient and drinking water. Food poisoning occurs every bit a result of consuming food contaminated with microorganisms or their toxins, the contamination arising from inadequate preservation methods, unhygienic treatment practices, cross-contagion from food contact surfaces, or from persons harboring the microorganisms in their nares and on the skin [5, 6]. Unhygienic practices during food preparation, handling and storage creates the conditions that allows the proliferation and manual of disease causing organisms such as bacteria, viruses and other food-borne pathogens [7, 8]. Additionally, many reported cases of nutrient-borne viral diseases have been attributed to infected food-handlers involved in catering services [nine].
In Republic of ghana, both public and private institutions ofttimes have food service or catering units where meals are served to both staff and clients. Such institutions may include schools, enquiry institutes, hospitals and prisons. To prevent outbreak of nutrient-borne diseases in these institutions, high standards of hygienic and safety practices by food-handlers are essential parts of an overall food safe plan implemented by these institutions. Although institutional nutrient-handlers may possess the required knowledge and skills needed in nutrient safety practice, errors due to human handling are oftentimes cited in several food-borne disease outbreaks [ten–12]. As Greig et al. [11] reports, almost 97% of reported food poisoning cases are due to the improper handling of foods by persons involved in catering services.
The knowledge, attitudes and practices of food-handlers have been reported in studies from different countries around world [13–xviii]. This is because a combination the three factors: knowledge, attitude and practice of nutrient-handlers, play dominant role in food safe with regards to food service manufacture [19]. In Ghana, previous studies have evaluated the knowledge, attitudes and practices of food-handlers in selected hotels in Accra [two], and nutrient hygiene practices past street food vendors [20]. Recently, food condom knowledge, attitudes and self-reported practices of food handlers in institutional foodservice in Accra-Ghana has also been reported [21]. All these studies were however limiting in scope as they were restricted to merely Accra, the capital letter urban center. At the moment, there is no published report on the knowledge, mental attitude and practice of nutrient-handlers in establishment selected from unlike geographical regions of Ghana. Such studies are however, important as they provide a nation-broad cess of training needs, attitudinal changes and effectiveness of training and education to provide continuous consumer assurance of the safety of food. Such investigations will also provide better understanding of the interactions of prevailing food safety knowledge, attitudes and practices of food-handlers throughout the state, Ghana.
This report therefore sought to assess the knowledge, attitudes, and practices of institutional food-handlers in Ghana, with regard to food aseptic practices and over-all safety.
Methods
Report population
A total of 235 institutional food-handlers participated in the study. A descriptive, cantankerous-exclusive survey of 29 institutions was employed in this study. The institutions included ten (10) Senior High Schools, 9 (9) District Hospitals, two (two) Prison Services, six (6) Universities/Polytechnics and ane (1) Wellness Research Center located in 5 administrative regions including Upper East, Northern, Ashanti, Volta, Brong-Ahafo and Eastern regions of Republic of ghana (Fig1).
Administrative regions of Ghana. Blue dot-circles indicate the regions from which institutional food handlers were sampled for the studies
Interviews
Contiguous interviews were conducted using structured questionnaire to collect information on the knowledge, attitudes and practices of the food-handlers on food rubber. The questionnaire was peer-reviewed and pilot tested in three institutions in the Upper Eastward Region of Ghana, before a final version was administered to food-handlers. Participants were interviewed by the researchers and trained inquiry assistants using the structured questionnaire. Data was collected betwixt Dec 2014 and June 2015.
The questionnaire was structured into 5 distinctive sections. Section one was to collect information on respondents' demographic characteristics such equally gender, age, level of education and length of employment in the food service business. Section two was concerned with data on the employees' work satisfaction while sections 3, 4 and 5 were concerned with information on employees' knowledge of food safety, attitude towards food safety and nutrient hygiene practices respectively.
Questions pertaining to demographic information of respondents and employees' work satisfaction were adapted from Soares et al. [22] and Jevšnik et al. [xvi]. Answers were graded on a scale of five, with 1 indicating "strongly disagree" and five indicating "strongly hold". Questions on food safety noesis, attitudes and practices were adapted from previously published works [xiii, 22–24].
The department of questionnaire dealing with food safety cognition comprised 25 close-ended questions with three possible answers; "true", "simulated", and "practice non know". These questions specifically dealt with respondents' knowledge of personal hygiene, cantankerous contamination, food-borne diseases, microorganisms, temperature control and hygienic practices. A scale ranging betwixt 0 and 24 (representing the total number of questions on food safety noesis) was used to evaluate the overall noesis of respondents. Nutrient-handlers that obtained full score ≤sixteen points were considered to have "insufficient" cognition and those that had scores ≥17 points (≥68% accurateness) were considered to take "good" knowledge of food safety.
Questions pertaining to attitudes (department 4) were aimed at determining the understanding of nutrient-handlers near food rubber. Hither, attitudes was used to hateful "a complex mental land involving beliefs, feelings, values and dispositions to deed in certain ways" [19]. This section had twenty statements/questions that required three possible responses: "concord", "disagree", and "don't know or remember". For evaluation, nutrient-handlers that answered to xiii or less statements/questions correctly were measured to have "insufficient or poor" understanding, whereas those that responded to fourteen or more statements/questions correctly were measured to have "good" understanding.
In section five, which dealt with nutrient hygiene practices, the practiced hygienic practices of respondents (institutional food-handlers) were assessed and evaluated based on self-reporting of personal hygiene and other safe food treatment practices. The section had eleven statements/questions with ii possible responses: "yes", and "no". Each correct exercise reported scored one (1) point. For evaluation, a score ≥ seventy% by an individual respondent was considered as having "good" nutrient hygienic practice.
Statistical analyses
The statistical parcel for social science (SPSS) for Windows (version 11.0, 2001, Chicago, IL) was used for analyses of data. Difference in means were considered statistically significant at p < 0.05. Mean scores of responses were converted into percentages for purposes of like shooting fish in a barrel estimation of results. One way assay of variance (ANOVA) was used to compare the hateful scores of knowledge, mental attitude, and practise among the dissimilar educational levels of respondents. The hateful score of noesis, mental attitude, and practice were compared by t-test. The responses were also reclassified into two chiselled responses 'yes' and 'no' for correct and incorrect responses respectively.
In society to identify the variables that impacted on the observed results, four logistic regression analysis models were adult. The four models included cognition of foodborne diseases, noesis and attitudes regarding personal hygiene, knowledge and attitudes regarding temperature control, and knowledge and attitudes towards food hygienic practices. Predictive variables including age, length of employment and education level were incorporated into all models with full general noesis on food safety every bit the dependent variable.
Results and discussion
Demographic characteristics
Table1 presents the summarized demographic profile of respondents in this study. Out of the 235 food-handlers who participated in this study, 76.half dozen% (n = 180) were female while 23.4% (n = 55) were males. Most studies accept reported higher proportion of females [22, 25, 26] involvement in food handling. A greater number (39.one%) of the participants were in the age bracket of 41–50 years with boilerplate age of 41.v ± nine.5 years. Similar studies showed that workers in older age brackets had improve hygiene scores than their younger colleagues [27, 28]. Approximately 14.5% of the participants in this report did not take any formal education. However, a previous study demonstrated that irrespective of educational level, employees performance in food rubber cognition was not satisfactory and thus a cause for public concern [29]. A greater number of participants (76.2%) had >v years of experience working in the foodservice industry with an average length of xi ± seven.viii years. Lxxx 3 per centum were total time workers in the institutions whiles the residue were part time workers. But a few (eight.i%) of the respondents self-reported that they accept ever received grooming in nutrient safety. Although several studies have shown that training may contribute to upgrading the food safety knowledge of nutrient-handlers, this does not always translate into a positive modify in food handling behavior and attitudes [12, xxx].
Table ane
Demographic characteristics of institutional food-handlers in Ghana (north = 235)
| Characteristics | Number | Percent | Mean ± SD | Range |
|---|---|---|---|---|
| Gender | ||||
| Female | 180 | 76.6 | ||
| Male | 55 | 23.four | N/A | N/A |
| Age (years) | ||||
| 21–xxx | eighteen | 7.vii | ||
| 31–twoscore | 78 | 33.two | ||
| 41–50 | 92 | 39.1 | ||
| 51–lx | 47 | twenty.0 | 41.5 ± nine.v | 22–60 |
| Marital status | ||||
| Single | 24 | 10.2 | ||
| Married | 161 | 68.5 | ||
| Divorced | 19 | eight.1 | ||
| Widow/widower | 31 | 13.ii | ||
| Education | ||||
| No formal education | 34 | 14.v | ||
| Basic | 91 | 38.seven | ||
| JHS/JSS | 57 | 24.iii | ||
| SHS/SSS | 13 | 5.5 | ||
| Post-secondary/Vocational | 22 | 9.4 | ||
| Tertiary | 18 | seven.half dozen | ||
| Length of employment (years) | ||||
| <5 | 56 | 23.8 | ||
| 5–10 | 61 | 25.9 | ||
| xi–20 | 109 | 46.4 | ||
| 21–thirty | 9 | 38.3 | 11 ± seven.viii | 0.5–thirty |
| Employment status | ||||
| Full-time | 197 | 83.8 | ||
| Function-time | 38 | sixteen.2 | ||
| Food prophylactic training course | ||||
| Yes | nineteen | eight.1 | ||
| No | 216 | 91.9 | ||
Employees' work satisfaction
Work satisfaction was surveyed to ascertain institutional nutrient-handler's satisfaction with the weather, work load, work relations and other people reaction toward them (Tabletwo). In general, 24.7% of the institutional food-handlers affirmed that if they had to choose a profession once more, they would choose the aforementioned profession, 48.5% said they would non choose the aforementioned profession, whiles 26.viii% were indifferent about the event of choosing a profession again.
Table 2
Employees' work satisfaction
| Statement/question | Response % (n) | ||
|---|---|---|---|
| Yes | No | Don't know | |
| If you could cull a profession, would you lot choose this same profession? | 24.7 (58) | 48.v (114) | 26.viii (63) |
| When you have personal problem, practice you share with your colleagues? | 60.0 (141) | 40.0 (94) | 0 (0) |
| When you accept personal trouble, did you lot share with your head of department? | 64.three (151) | 35.7 (84) | 0 (0) |
| Would you lot leave this piece of work if yous are offered something ameliorate at another place? | 95.3 (224) | 0.0 (0) | 4.7 (11) |
| Is the work load acceptable? | 92.3 (217) | seven.7 (eighteen) | 0 (0) |
| Is the kitchen staff respected by other workers of the institution? | 14.9 (35) | 85.1 (200) | 0 (0) |
| Does the workplace provide all the necessary conditions to guaranteeing nutrient condom? | 62.1 (146) | 37.ix (89) | 0 (0) |
| Do the meals served present health risks to the people? | 0 (0) | 100.0 (235) | 0 (0) |
In answering the question; would y'all quit this work if you are offered something better at a different identify, about 95.3% affirmed they will get out while iv.7% were not certain. About 62.1% said the workplace make available all the necessary atmospheric condition for guaranteeing food safety. On the issue of sharing problems, 64.3% agreed that they do share their personal issues with their head of departments.
Food safety knowledge of food-handlers
In our report, the food-handlers were knowledgeable about hygiene practices, cleaning and sanitation procedures (Table3). Bulk of nutrient-handlers in this report knew the importance of general germ-free practices such as regular manus washing at the work place (98.7% correct answers), wearing of gloves (77.9% right answers), proper cleaning (86.4% correct answers) and detergent apply (72.8%).
Table 3
Food safe knowledge of institutional food-handlers in Ghana
| Statement | Response % (n) | ||
|---|---|---|---|
| Correct | Incorrect | Don't know/remember | |
| Washing easily before work reduces the risk of food contamination. | 98.7 (232) | 0.0 (0) | 1.3 (3) |
| Using gloves while handling nutrient reduces the risk of food contamination. | 77.ix (183) | 17.4 (41) | 4.vii (11) |
| Proper cleaning and sanitization of utensils increment the risk of food contamination. | iv.7 (xi) | 86.4 (203) | 8.9 (21) |
| Eating and drinking at the work place increase the take a chance of nutrient contamination. | 25.1 (59) | 60.9 (143) | 14.0 (33) |
| Food prepared in advance reduces the risk of nutrient contamination. | 21.3 (50) | 68.ane (160) | x.half-dozen (25) |
| Reheating cooked foods can contribute to food contamination. | 11.v (27) | seventy.half-dozen (166) | 17.9 (42) |
| Washing utensils with detergent leaves them free of contagion. | 72.viii (171) | 26.viii (63) | 0.4 (1) |
| Children, salubrious adults, meaning women and older individuals are at equal risk for food poisoning. | 60.9 (143) | 37.9 (89) | 1.two (3) |
| Typhoid fever tin can be transmitted by food. | 81.7 (192) | xiii.6 (32) | 4.seven (11) |
| AIDS can be transmitted by food. | 8.five (xx) | 86.viii (204) | iv.vii (eleven) |
| Bloody diarrhea tin can be transmitted by food. | 87.7 (206) | 8.1 (19) | iv.2 (10) |
| Salmonella is among the nutrient-borne pathogens. | 18.iii (43) | five.5 (13) | 76.2 (179) |
| Hepatitis A virus is among the food-borne pathogens. | eleven.5 (27) | 17.9 (42) | seventy.6 (166) |
| Swollen cans may contain the microorganism, Clostridium botulinum, which causes botulism. | 13.6 (32) | ten.two (24) | 76.2 (179) |
| Microbes are on the skin, in the nose and mouth of healthy food handlers. | 71.5 (168) | 25.1 (59) | 3.iv (8) |
| Make clean is the same as sanitized. | 60.0 (141) | 33.half-dozen (79) | half dozen.four (15) |
| Cross contamination is when microorganisms from a contaminated food are transferred by the food handler's hands or kitchen utensils to another nutrient. | 4.seven (11) | 8.ix (21) | 86.4 (203) |
| The correct temperature for storing perishable foods is 5 °C. | 33.6 (79) | 6.4 (15) | threescore.0 (141) |
| Hot, set up-to-eat food should exist kept at a temperature of 65 °C. | sixty.0 (141) | half-dozen.4 (15) | 33.half dozen (79) |
| Freezing kills all the bacteria that may cause food-borne illness. | 59.one (139) | 39.2 (92) | 1.seven (4) |
| Contaminated foods always have some change in color, odor or taste. | lx.4 (142) | 39.2 (92) | 0.4 (i) |
| Raw vegetables are at college risk of contamination than undercooked beef | 40.ix (96) | 28.9 (68) | 30.2(71) |
| During infectious disease of the skin, it is necessary to take get out from work. | 93.6 (220) | 0.0 (0) | half dozen.4 (15) |
| The health status of workers should be evaluated before employment. | 99.vi (234) | 0.four (one) | 0.0 (0) |
| The ideal identify to shop raw meat in the refrigerator is on the bottom shelf. | 40.9 (96) | 28.nine (68) | xxx.two(71) |
The awareness of such important hygienic procedures by bulk of the institutional food-handlers in this report is very advisable. This is because the hands of nutrient-handlers can serve as vectors in the spread of foodborne diseases due to poor personal hygiene or cantankerous-contamination [14, 31]. Proper hand washing past nutrient-handlers has been reported to significantly decrease the threat of diarrheal affliction in child care facilities [32] and can therefore be encouraged as information technology could similarly assistance minimize the take a chance of diarrhea and other foodborne diseases in similar institutions. Despite a self-reported hand washing expert by food-handlers, many employees' in a study by Stepanović et al. [33] had coagulase-positive staphylococci isolated from their hands, and this could be a source of food contamination. Therefore, it is prudent to combine proper manus washing with the wearing of gloves and other aseptic practices in gild to minimize the chance of contagion during food handling [34].
Regarding foodborne illness manual, 76.two% of the nutrient-handlers (respondents) did not know or think that Salmonella is a food-borne pathogens and 70.half-dozen% did not know/retrieve that hepatitis A is a foodborne pathogen. On the other, 81.7 and 87.7% of respondents agreed that typhoid fever and encarmine diarrhea respectively can exist transmitted by food. The bulk (86.8%) of respondents disagreed that HIV/AIDS is transmitted by food, which is an indication that public pedagogy on HIV/AIDS by the Ghana AIDS commission could exist yielding results. These results back up recently published piece of work where bulk of the respondents did not know if Salmonella, hepatitis A and B viruses, and Staphylococcus caused foodborne diseases [thirteen, 22]. Over ninety percentage (90%) of respondents agreed that taking exit from work in periods of infectious pare disease was necessary (Table3). Additionally, 71.5% knew that microorganisms tin be found on the skin and in the oral fissure and nose of good for you looking individuals. They also recognize that the health status of nutrient-handlers should exist assessed prior to employment.
On the other paw, food-handlers were less familiar with time and temperature abuse and its effect on food condom (Tabular array3). Betimes [35] reported that improper handling of food, including the abuse of time-temperature, account for most food-borne illness outbreak. In this study, respondents had bereft noesis on time-temperature controls. This result is supported by others [14, 29] whose study show that knowledge of critical temperatures were insufficient among food-handlers. Like findings on the lack of acceptable cognition on temperature controls by food-handlers have besides been reported from different countries [36–38].
Food condom attitudes of food-handlers
A reduction in the incidence of food-borne illnesses is strongly influenced by the attitudes of nutrient-handlers towards the implementation of food rubber plans. Thus, there is a strong linkage betwixt positive behavior, attitudes and education of food-handlers in maintaining prophylactic food handling practices [12].
Table4 shows the attitudes of the food-handlers toward the prevention and control of food-borne diseases. About 60% of respondents indicated that using caps, masks, protective gloves and proper habiliment tin minimize the risk of food contagion, which is a positive mental attitude reported by bulk of the respondents. Similarly, majority of respondents (93.6%) agreed that knives and cutting boards should be properly sanitized to forbid cross contamination of foods. Respondents besides agreed that individuals with abrasions or cuts on their fingers or easily should not touch unwrapped foods (87.2%). The bulk (88.1%) of food-handlers were enlightened that food should not be handled with long and painted fingernails. They were also mindful of the fact that dish towels could cross-contaminate foods (71.5%) and that well-cooked foods are free of contamination (86.4%). Thus, the general attitudes of the food-handlers toward food safety was satisfactory, except on issues relating to refrozen of defrosted nutrient. About 81.seven% of food-handlers had unsatisfactory attitude towards defrosted and refrozen foods. Refreezing a completely thawed nutrient tin present a serious wellness run a risk, as this process leads faster growth of contaminating bacteria. Freezing food only slows bacterial growth and does not necessarily impale the pathogens [39]. Respondents (86.four%) did not notice it necessary to check the temperatures of refrigerators and freezers periodically (86.4%).
Table 4
Food safe attitudes of institutional food-handlers
| Statement | Response % (n) | ||
|---|---|---|---|
| Concur | Disagree | Don't know/call up | |
| Well-cooked foods are free of contamination | 86.4 (203) | 8.9 (21) | iv.vii (eleven) |
| Proper hand hygiene tin can foreclose food-borne diseases. | 93.6 (220) | 0.0 (0) | 6.four (15) |
| When cleaning products are closed, they tin can exist stored with cans and jars of nutrient that are as well closed. | 28.9 (68) | 30.2(71) | twoscore.9 (96) |
| Raw and cooked foods should exist stored separately to reduce the take chances of food contagion. | twoscore.9 (96) | 28.9 (68) | xxx.ii(71) |
| It is necessary to check the temperature of refrigerators/freezers periodically to reduce the risk of nutrient contamination. | 33.half-dozen (79) | 8.9 (21) | 86.iv (203) |
| Defrosted foods should not be refrozen. | 13.6 (32) | 81.7 (192) | four.7 (11) |
| The health status of workers should be evaluated before employment. | 60.0 (141) | 6.four (15) | 33.6 (79) |
| The best way to thaw a chicken is in a bowl of cold water. | 87.vii (206) | 8.1 (19) | four.2 (ten) |
| Wearing masks is an important practise to reduce the risk of food contamination. | 60.0 (141) | 6.4 (xv) | 33.6 (79) |
| Wearing gloves is an important practice to reduce the adventure of food contamination. | threescore.0 (141) | half-dozen.4 (15) | 33.half-dozen (79) |
| Wearing caps and adequate clothing is an of import practice to reduce the gamble of food contamination. | sixty.0 (141) | 6.4 (15) | 33.vi (79) |
| Safe food handling is an of import part of my task responsibilities | 40.9 (96) | 28.9 (68) | 30.2 (71) |
| Learning more well-nigh food safety through training courses is important to me | thirty.2 (71) | 28.9 (68) | 40.9 (96) |
| Beards could contaminate nutrient with foodborne pathogens | 13.6 (32) | ten.2 (24) | 76.2(179) |
| Long and painted fingernails could contaminate food with foodborne pathogens. | 88.i (207) | 11.nine (28) | 0 (0) |
| Food handlers can exist a source of foodborne outbreaks | 64.three (151) | 35.seven (84) | 0 (0) |
| Eggs must exist washed immediately subsequently delivery. | 24.7 (58) | 48.5 (114) | 26.8 (63) |
| Dish towels can exist a source of food contamination. | 71.5 (168) | 25.ane (59) | 3.iv (8) |
| Knives and cutting boards should exist properly sanitized to foreclose cross contamination. | 93.6 (220) | 0 (0) | half-dozen.4 (15) |
| Food handlers who accept abrasions or cuts on their hands should not touch foods without gloves. | 87.2 (207) | 0 (0) | 12.viii (30) |
Nutrient safe practices by nutrient-handlers
Table5 shows the nutrient safety practices by institutional food-handlers. In assessing the food safe practices of the institutional nutrient-handlers, 88.1% reported that they do not utilise gloves during the distribution of unpackaged foods. Majority (61.7%) of the food-handlers do not utilize aprons or habiliment mask when necessary. Additionally, they consume and potable during working hours. On sanitizer use, 61.7% reported that they do not use sanitizer in washing utensils such equally plates, mugs and spoons. All respondents reported that they do not use sanitizer when washing fruits or vegetables. Virtually 83.8% of the institutional food-handlers practise prepare meals in advance. Only 17% of respondents reported that they expect out for the shelf-life of foods when taking delivery of them.
Table 5
Food safe practices amongst institutional food-handlers
| Question | Response % (n) | |
|---|---|---|
| Aye | No | |
| Do y'all use gloves during the distribution of unpackaged foods? If no, become to question 3. | 11.9 (28) | 88.1 (207) |
| Do you wash your easily properly before or later on using gloves? | 64.2 (eighteen) | 35.7 (ten) |
| Do you lot wear an apron while working? | 38.3 (90) | 61.seven (145) |
| Exercise you clothing a mask when you distribute unwrapped foods? | 38.3 (90) | 61.7 (145) |
| Do yous swallow or beverage at your work place? | 93.6 (220) | 6.4 (xv) |
| Do you wear smash polish when treatment food? | xvi.2 (38) | 83.eight (197) |
| Do you lot prepare a meal in accelerate (i.due east., from one shift to another)? | 83.eight (197) | 16.2 (38) |
| Practice you properly clean the nutrient storage expanse before storing new products? | 87.2 (207) | 12.viii (30) |
| Do yous use the sanitizer when washing service utensils (plates, mugs and spoons)? | 61.7 (145) | 38.iii (90) |
| Practise you apply the sanitizer when washing fruits? | 0.0 (0) | 100 (235) |
| Exercise you check the shelf life of foods at the time of delivery? | 17 (40) | 83 (195) |
Some previous studies suggest that the lack of knowledge in food safety can lead to poor hygienic practices past food-handlers [27, 40]. Still, Clayton et al. [41] reported that almost 63% of nutrient-handlers demonstrating cognition in food safety did not demonstrate a respective positive behavior towards food safety/aseptic practices. This shows that food-handlers might not necessarily be practicing strict nutrient safety procedures during food handling, fifty-fifty when they provide answers to show that they are knowledgeable in a survey. Therefore, other factors such as employee motivation and continuous education and training on the task should be provided to inspire food-handlers, which will affect attitudes and afterwards food-safety practices [42].
Logistic regression analyses
Logistic regression analysis testing iv models to identify the variables that impacted on the observed results are shown in Tabular array6. All models tested except model 2 showed statistically significant differences (p < 0.05). The pregnant differences were merely observed for models in which the explanatory variable was the level of teaching. Thus with the exception of model ii, respondents having advanced specific cognition demonstrated significantly improve agreement of food safety issues. For example, in model ane, the results indicate that food-handlers that demonstrate good knowledge of Hepatitis A virus as a nutrient-borne pathogen had an adjusted OR of 14.three (CI95, P = 0.002). Thus, these nutrient-handlers have 14.3 more than times possibilities of having good level of food safety noesis when compared with food-handlers lacking sufficient level of knowledge for the same variable.
Table 6
Logistic regression analyses
| Variables | OR adjusted | P-value |
|---|---|---|
| Model 1 | ||
| Cognition about adventure group for food-borne illness | 14.2 | 0.001 |
| Knowledge virtually HIV every bit a food-borne disease | viii.4 | 0.004 |
| Knowledge about Hepatitis virus as a food-borne pathogen | fourteen.iii | 0.002 |
| Knowledge about Staphylococcus every bit a food-borne pathogen | iii.9 | 0.017 |
| Knowledge about Clostridium equally a food-borne pathogen | 7.6 | 0.002 |
| Knowledge about microorganisms versus health of food handlers | xiii.ii | 0.003 |
| Level of education | 5.i | 0.000 |
| Model 2 | ||
| Cognition of gloves use | 0.8 | 0.104 |
| Noesis of masks utilise | 1.three | 0.052 |
| Knowledge virtually eating or drinking during working hours | i.4 | 0.080 |
| Practise about eating or drinking during working hours | two.5 | 0.063 |
| Level of education | 4.two | 0.030 |
| Model 3 | ||
| Noesis about freezing versus microorganisms | 3.8 | 0.003 |
| Knowledge about refrigeration temperature | three.five | 0.001 |
| Level of instruction | iii.9 | 0.004 |
| Model 4 | ||
| Knowledge near nutrient contagion versus attributes of food that may betoken contagion | 6.4 | 0.010 |
| Knowledge of shelf-life | 3.5 | 0.003 |
| Level of education | 4.five | 0.001 |
Conclusions
In general, institutional food-handlers in Republic of ghana had satisfactory knowledge in the areas of food safety, general and personal hygiene, cleaning and sanitation procedures. Nonetheless, this did non translate into strict food hygiene practices. Therefore continuous food safety educational activity and motivation for food-handlers of diverse demographic backgrounds with special attention paid to those with lower levels of education would complement other interventions that pursue the enhancement of food safety systems in Ghana.
Acknowledgements
The authors would like to thank the staff and the participants of the diverse institutions visited for their contributions.
Availability of data and materials
The authors declare that the information supporting the findings of this written report are fully described within the manuscript.
Authors' contributions
FA and JOK designed the study, analyzed and interpreted the data, discussed the results, wrote, edited and drafted the newspaper with equal contributions at all levels. EHH participated in the design of questionnaire, collected and complied the information. All authors have read and canonical the terminal version of the manuscript.
Author details
FA and JOK are both lecturers at the Department of Applied Biology, Faculty of Applied Sciences, University for Development Studies, P. O. Box 24, Navrongo-campus, Ghana. EHH is a graduate assistant at the Academy for Development Studies, Republic of ghana.
Competing interests
All the authors declare that they practise non have any competing interests.
Consent to publish
Not applicable. The published information does not contain details that could exist traced to any individual respondent.
Ideals approval and consent to participate
All respondents provided written informed consent before participating in the study. The study was considered to belong to exempt category review for ethical approval due to minimal risk to respondents. Waiver from approval was discussed with, and granted by the Navrongo Health Research Middle Institutional Review Board (NHRCIRB), Ghana.
Abbreviations
| AIDS | Acquired immune deficiency syndrome |
| HACCP | Hazard assay critical command indicate |
| JHS/JSS | Junior high school/junior secondary school |
| KAP | Cognition mental attitude and exercise |
| SHS/SSS | Senior loftier school/senior secondary school |
| WHO | Globe health organization |
Contributor Information
Fortune Akabanda, Phone: +233 209087076, Electronic mail: moc.liamg@adnabakaf.
Eli Hope Hlortsi, Email: moc.oohay@istrolhileepoh.
James Owusu-Kwarteng, Email: hg.ude.sdu@gnetrawkusuwoj.
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What Virus Is Spread By Food-service Workers' Poor Personal Hygiene?,
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