The factors influencing food contamination by salmonella, escherichia coli and staphylococcus species among food handlers at Kenyatta National Hospital

Abstract

Food borne diseases caused by Staphylococcal, E. coli and Salmonella food poisoning have continued to be a major public health problem worldwide. In Kenya, Staphylococcal, E. coli and Salmonella food poisoning have been responsible for outbreaks of diseases in rural and urban areas. Improper food handling practices among food handlers have been implicated as a vehicle of transferring Staphylococcus, E. coli and Salmonella pathogen. Much work has not been carried out in Kenya to determine the relationship between food handling and the occurrence of food contaminants. This formed the basis of the study. The main objective of this study was to establish food handling practices as a sauce of Salmonella, E. coli and Staphylococcus pathogens in fried chicken resulting from lack of knowledge on proper food handling and poor hygiene practices of food handlers. The study adopted a descriptive survey and analytical procedure was carried out in the four kitchens of Kenyatta National Hospital. A total of 125 key informants participated in the study. This included 20 catering officers, 5 store men, 5 public health officers and 95 food production and service staff. Simple random sampling method was used in selecting catering officers, food production and service staff. All store men and public health officers working in the kitchens were included in the study. Closed ended questionnaire were used in testing the knowledge level on hygienic practices among food handlers. Observation checklists were used in capturing the non verbal occurrences related to food handling practices. Representative samples of fried chicken were collected from four kitchens (Canteen, Rahimtualla, Sister Mess and Private wing) for microbiological analysis. Hand and surface swabs were also collected from all kitchens in identifying any presence of Staphylococcus and E. coli. Data collected was analysed using descriptive method and statistical package of social sciences (SPSS) computer software. The descriptive analysis was presented using tables and figures. Chi-square (x2) at 95% confidence level was used to test significance association of variables. One way Analysis of variance (ANOVA) was used to test for significance differences of means of different kitchens. The findings revealed that more (65.4%) than half of the food handlers were knowledgeable in appropriate food handling practices. There was slight difference however between scores in aptitude (knowledge level) items (65.4%) and the actual implementation of the same (observed hygienic practices 64.3%). The overall results of food analysis indicated that no pathogen was isolated in the food immediately after cooking. Salmonella was not also isolated in food after cooking and before service. However, the presence of Staphylococcus aureus and E. coli was noted in some food samples. There was a significant relationship between washing of hands before handling food and visiting toilet and the presence of pathogens in food. Based on these findings adequate and continuing training of every food handler in food hygiene was recommended. Other recommendations included Hazard Analysis Critical Control Point system in all kitchens, routine medical examination of food handlers, routine sampling of cooked food, construction of wash hand basins adjacent to the toilets and sensitization of caterers on close monitoring of production and service staff.