The observance of food hygiene and safety by food vendors is one of the most important factors in the prevention of foodborne diseases
1.7 billion children under the age of five years suffer from diarrhea each year accounting for more than 3 million deaths. 1/3 of this burden is related to foodborne illnesses and Africa bears the biggest burden
The study was conducted amongst 172 participants. We had 91% of women and 9% men. Age range from 18 – 70 years. From our distribution, we have an average age of 34. Socio- demographic, cultural, and behavioral data on study informants are presented in Table 1.
|
Frequency |
Percentage (%) |
Respect of hygienic rules |
P-valeur |
|
|
No |
Yes |
|||
|
15 |
8,72 |
93,3 |
6,7 |
0,008* |
|
157 |
91,28 |
58,6 |
41,4 |
|
|
41 |
23,8 |
80,4 |
4,6 |
0,003* |
|
54 |
31,3 |
70 |
30 |
|
|
40 |
23,2 |
55 |
45 |
|
|
37 |
21,5 |
46 |
54 |
|
|
18 |
10,47 |
16,6 |
83,3 |
0* |
|
83 |
48,26 |
21,7 |
78,3 |
|
|
66 |
38,37 |
63,6 |
36,4 |
|
|
5 |
2,91 |
60 |
40 |
|
|
101 |
58,7 |
54,5 |
45,5 |
0,021* |
|
71 |
41,3 |
71,8 |
28,2 |
|
|
0 |
0 |
,0 |
,0 |
|
|
143 |
83,1 |
65,7 |
34,3 |
0,014* |
|
29 |
16,9 |
41,4 |
58,6 |
|
|
80 |
46,5 |
46,3 |
53,8 |
0* |
|
92 |
53,5 |
75,0 |
25,0 |
|
|
74 |
43,0 |
33,8 |
66,2 |
0* |
|
98 |
57,0 |
82,7 |
17,3 |
|
|
130 |
75,6 |
50,0 |
50,0 |
0* |
|
42 |
24,4 |
97,6 |
2,4 |
|
|
151 |
87,8 |
56,3 |
43,7 |
0* |
|
21 |
12,2 |
100,0 |
,0 |
|
|
62 |
36,0 |
32,3 |
67,7 |
0* |
|
110 |
64,0 |
78,2 |
21,8 |
|
|
57 |
33,1 |
28,1 |
71,9 |
0,017* |
|
5 |
2,9 |
80,0 |
20,0 |
|
|
152 |
88,4 |
57,9 |
42,1 |
0,006* |
|
20 |
11,6 |
90,0 |
10,0 |
|
|
83 |
48,3 |
37,3 |
62,7 |
0* |
|
89 |
51,7 |
84,3 |
15,7 |
|
|
84 |
48,8 |
41,7 |
58,3 |
0* |
|
88 |
51,2 |
80,7 |
19,3 |
|
|
69 |
40,1 |
37,7 |
62,3 |
0,112 |
|
15 |
8,7 |
60,0 |
40,0 |
|
|
90 |
52,3 |
36,7 |
63,3 |
0* |
|
82 |
47,7 |
89,0 |
11,0 |
|
|
48 |
27,9 |
31,3 |
68,8 |
0* |
|
124 |
78,1 |
73,4 |
26,6 |
|
|
44 |
25,6 |
27,3 |
72,7 |
0* |
We conducted a cross-sectional study in the Bénoué division of Cameroon from March to November 2016. We proceeded by a mixed-method approach (A quantitative component which comprised analyzing cultural and behavioral determinants of non-compliance by commercial food vendors and a qualitative component by using direct observation to enable us to triangulate the related practice and behavior observed). All commercial food vendors in primary and secondary schools in the Bénoué division aged over 18 who freely and voluntarily gave their consent were enrolled in the study.
2.2.Population
All persons who selling food in the primary and secondary schools were source population of the study
2.3.Eligibility Criteria All food vendors of
The Bénoué division was stratified by district (12 districts). We randomly sampled 3 districts for our investigation. First, the exhaustive list of schools (primary and secondary) in these 3 districts (Garoua 1, Garoua 2, and Garoua 3) was drawn up as well as the number of food vendors (on average 4 per schools). Secondly, we proceeded by a 1 in 3 survey steps to enroll in the schools under investigation. This is illustrated as follows:
Enrollments of primary schools in the division (district of Garoua 1, 2 and 3): 84
Number of secondary schools (Garoua district 1, 2 and 3): 38
We proceeded using stratified sampling of schools within these three councils were all schools (127) were listed and enrolled for investigation. We further wrote the school's names and balloted randomly to obtain the first school. We later surveyed each school after a pitch of 3, the average of 43 schools to be surveyed was established, which gives a total of 172 food vendors (116 in primary schools and 56 in secondary schools).
We used a structured questionnaire for quantitative data and direct observation for qualitative assessment.
Wear clean, decent clothes;
Wash your hands with soap and clean water before and after any food handling, after going to the toilet, after handling dirty objects, after touching raw food, after handling toxic or dangerous objects, and whenever necessary;
Keep your hands always short and clean;
Have clean and combed hair and hold it by a cap, cap, or fishnet during operations;
Refrain from any practice contrary to hygiene, whether it is spitting or scratching your nose, ears or other body openings;
Do not sneeze or cough on food
The quantitative data were entered into the software CSPro later transferred to SPSS for analysis. A Chi-square test was performed to determine statistically significant variables. We ran a binary logistics analysis to observe the level of association between the variables of interest n and the independent variables.
We obtained ethical clearance (No 2016/0344/CEIRSH/ESS/MSP/ of 22/07/16) from the IRB of the school of Health Science Catholic University of Central Africa. An information sheet was provided to participants explaining in-depth the objectives, benefits, and risks of participation. Participation was free and voluntary. A signed written informed consent form was provided by each respondent before the commencement of the study.
The results show that Christians are more likely to comply with food hygiene rules in contrast to Muslims (p <0.021). 43% of participants were aware of good hygienic rules for food sales. Of those, 17.3% respected these hygiene rules, while 82.7% did not (p <0.000).
Knowing the different compositions of the food sold can have an impact on this respect of hygienic rules. Indeed, food vendors who knew the value of what they sold, demonstrated better respect of hygiene rules (p <0.000). Of the 172 food vendors surveyed, vendors with dirty nails were likely not to comply with hygiene rules (97.6%) unlike those with clean nails (p <0.000). 52.3% of food vendors owned a trash can. Some schools in the study area had placed trash cans at various spots in their school premises. This study shows that schools with such cans in their environment practiced better hygienic rules (P = 0.000).
The clothes of vendors were not generally clean. Food vendors wearing dirty clothes (100%) did not respect basic food hygiene rules (p <0.000), they did not bother to wash their clothes and besides, they continue to wipe their hands on these dirty dresses every time they finish serving food. We also observed that wearing an apron has an impact on compliance with food hygiene rules. Indeed, food vendors with aprons showed better respect of hygiene rules (p<0.000) in contrast to those without.
The main focus of this study was to identify and analyze the cultural and behavioral determinants of non-compliance of hygiene rules by food vendors in primary and secondary schools in the Bénoué division (North Cameroon). Therefore, the discussion of our results is linked to the literature and empirical data notably, knowledge about the value of food sold; nails hygiene, and regular handwashing; availability and use of a trash can; physical appearance and dressing attire; and wearing of aprons.
In comparison with existing literature, a similar observation was found by
Knowing the different compositions of the food sold can have an impact on this respect of hygienic rules. Indeed, the theory of reasoned action makes it clear that knowledge acquired can influence behavior. People with an idea of the benefits of a product are more likely to use it better than those without. Through this theory, and after deduction, knowing the energy values of the food sold has an impact on compliance with hygiene rules.
Of the 172 food vendors surveyed, vendors with dirty nails were likely not to comply with hygiene rules (97.6%) unlike those with clean nails (p <0.000). This can be explained by the fact that these food vendors do not know the basic rules regarding hand hygiene and the consequences of not washing hands and the risk of disease transmission. This result correlates with those of Charles et al. Likewise, 2/3 of the respondents did not practice hand washing before serving food (78.1%) and among them, 73.4% did not respect basic food hygiene rules. This can be explained by a lack of awareness of the importance and principles of handwashing by these food vendors. However, the guide to good hygiene and food safety practices recommends that people who are in contact with food wash their hands and forearms before serving food.
From our analysis, 52.3% of food vendors owned a trash can. Some schools in the study area had placed trash cans at various spots in their school premises. This study shows that schools with such cans in their environment practiced better hygienic rules (P = 0.000). In contrast with
The clothes of vendors were not generally clean. Food vendors wearing dirty clothes (100%) did not respect basic food hygiene rules (p <0.000), they did not bother to wash their clothes and besides, they continue to wipe their hands on these dirty dresses every time they finish serving food.
We observed that wearing an apron has an impact on compliance with food hygiene rules. Indeed, food vendors with aprons showed better respect of hygiene rules (p <0.000) in contrast to those without. The literature review shows the importance to distinguish between work clothes and private clothes to limit the proliferation of germs.
Despite the relevance of the results obtained one of the key limitations of this study is that we were not able to conduct a nutritional analysis on the quality of the food items sold.
Nevertheless, as far as public health issues are concerned, for the first time in Cameroon, this study attempted to provide statistical evidence on hygienic practices by food vendors in schools.
This study on characterizing factors related with non-compliance to hygienic rules by commercial food vendors in primary and secondary suggests the necessity to organize awareness campaigns on food hygiene rules; establish a certain number of guarding principles (wearing of aprons, frequent hand washing, owning a trash can, and getting basic training in quality food hygiene practices) to food vendors before they engage into this activity; recommend hand washing washbasins with water and soap to food vendors where they can wash their hands. Otherwise, they must have a disinfectant gel. Besides, we also suggested installing trash cans in the sale point and the school must ensure that these cans are completely emptied by the end of each day. Similarly, vendors are recommended to locate further from school sports complexes, and toilets.
What is already known on this topic: includes a maximum of 03 bullet points on what is already known on this topic
School feeding is a very important element in the education and success of the child
Compliance with hygiene measures reduces the frequency of diseases linked to poor food conservation and consumption.
What this study adds: include a maximum of 03 bullet points on what your study adds
The study gives an overview of the epidemiological profile of diseases linked to the consumption of poorly handled in the school milieu.
The study makes available baseline data for future researchers on cultural and behavioral factors that influence compliance with poor food hygienic practices.
We also express gratitude to the schools for giving us access to investigate in their premises and all the participants who took part in this study.
UD, AS, designed the study, UD, AS, MN analyzed the data and produced the first draft of the study. All authors extracted the manuscript and approved the final draft.