Prevalence and factors associated with intestinal parasites among food handlers in Medebay Zana District, North West Tigray, Northern Ethiopia.

doi:10.21203/rs.2.23962/v3

Download PDF

Research

Prevalence and factors associated with intestinal parasites among food handlers in Medebay Zana District, North West Tigray, Northern Ethiopia.

https://doi.org/10.21203/rs.2.23962/v3

This work is licensed under a CC BY 4.0 License

Journal Publication

published 31 Jan, 2021

Read the published version in Tropical Diseases, Travel Medicine and Vaccines →

You are reading this older preprint version

Read the latest preprint version →

Introduction: Several epidemiological studies suggest that the prevalence of intestinal parasites is high, especially in developing countries, and are amongst the major public healthchallenges facing Sub-Saharan Africa.The aim of the study was to determine the prevalence of intestinal parasites and its associated factors among food handlers in Medebay Zana District, Tigray, Ethiopia.

Methods: A cross-sectional study was conducted among 401 food handler individuals selected by systematic random sampling.Binary and multivariable logistic regression was used to determine the possible association between the independent variable and outcome variables. Statistical significance was declared at p-value <0.05 with a 95% confidence interval.

Result: The prevalence of intestinal parasites was 33.2% within this sample. The dominant parasite was Entamoeba coli 50(37.4%), followed by Entamoebahistolytica/dispar 24(18%), Entamoeba hartmanni 18(13.5), Giardia lamblia 17(12.8%), Schistosoma mansoni 8(6%), Hymenolepis nana 7(5.3%), Entervious vermicularies 6(4.5%) and Taenia species 3(2.5%).

Conclusion: This study revealed a high prevalence of intestinal parasites among food handlers for a range of intestinal parasites. The significant predictors werethe source of water, washing hands before food preparation, washing hands with soap and water after visiting the toilet, shower installation at workplace, washing the body regularly, and eating raw vegetables and raw meat. Hence, local health planners should implement appropriate interventional measures for the novel risk factors to mitigate the problem.

Parasitology

Intestinal Parasites

Food handlers

Ethiopia

Infection with intestinal parasites remains a major public health challenge in developing countries where poor environmental sanitation, poor personal hygiene, and a low level of education are prominent[1]. Globally, about one-third of the total population is estimated to be infected with intestinal parasites, the majority being people living in tropical and sub-tropical parts of the world [2]. The World Health Organization (WHO) estimated that at least one-quarter of the world’s population is infected with soil-transmitted helminths[3]. Worldwide, about 300 million people suffer from severe helminthic infections, leading to morbidity and over 150,000 deaths annually[4]. The reasons for the incidence of parasites include climatic conditions, local traditions, and the use of human and animal fertilizers in agriculture and vegetable planting[5]. Food sold in markets may be contaminated by hands that have not been washed after defecation or from carriers that land on both food and feces, thereby increasing the risk of transmission of intestinal parasites to consumers[6].

Regarding the etiologies, Ascaris lumbricoides, Trichuris trichiura, Hook worm, Entamoeba histolytica, and Giardia lamblia were the common causes [7]. As in many developing countries, cases of intestinal parasites are highly abundant in Ethiopia. The country has the second-highest burden of Ascariasis, the third highest burden of hookworm, and the fourth highest burden of Trichuriasis in Sub-Saharan Africa[8].

Industrializationand urbanization have promoted people to migrate from rural to urban areas, forcing them to have their meals at any place at an affordable price. In urban areas, there is mushrooming of eating establishments due to increased demand with the concomitant potential to spread of disease via food handlers [9].

The epidemiology of intestinal parasitesremains complex because of the diversity of associated factors involved, with the complexities of control highly relevant to addressing this escalating challenge [10]. In Ethiopia, particularly in the study area, intestinal parasitosis is a steadily increasing public health concern [11, 12]. On the other hand, the study area is not researched and there is a paucity of scientific information in the region at large. Therefore, this cross-sectional study was conducted to assess the prevalence and associated factors of intestinal parasites among food handlers in Medebay Zana district Towns, Tigray, Ethiopia which can be an input for timely interventional measures on the actual risk factors.

Study area, design and period

This cross-sectional, community-based study was conducted among food handlers working in food service establishments in Medebay Zana district Towns from January 2019 to February 2019. Medebay Zana districtis is about 1040kms from Addis Ababa. In the district, therewerea total of 277 restaurants and hotels, 44 snack bars and 52 food bakeries. These establishments can accommodate a total of 1850 people. In total, in the hotels, restaurants and snack bars found in the district, there are 1050food handlers.

Population

All food handlers who were working in Medebay Zana district Towns were the target population; randomly selected (see the sampling technique) food handlers formed the study population. Food handlers who wereunder treatmentor those who finishedtreatmentfor parasitic infectionwithin two weeks prior to the study were excluded.

Sample size and sampling technique

The sample size was determined using the following assumptions (level of confidence of the population is taken to be 95% and Zα/2=1.96).A 5% margin of error (d=0.05) and the prevalence of intestinal parasites among food handlers were based on a previously conducted study in Ethiopia, Tigray Mekelle Town at 49.3 %[11]. Based on these assumptions, the actual sample size for the study is computed using one sample population proportion formula as indicated below.

n = (Zα/2)²P (1-P)/d²

Then, the sample size was, n ≈ 384+10% contingency=422. The total sample size was proportionally allocated according to the number of food handlers working in hotels, snack bars, and bakeries; a systematic random sampling technique was then employed to select the allocated number of study participants from the sampling frame.

Data collectiontools

Interviewers administered structured questionnaires were used to collect the data. The content of the questionnaire included socio-demographic characteristics, educational status, economic status, individual behavioral factors, and house characteristics as well as environmental related conditions.

Laboratory investigation

Fecal specimens were obtained from the selected food handlers and transported to the laboratory-based on the standard operating procedures for the collection and transportation of fecal specimens.In the laboratory, the stool was immediately examinedby wet mount technique for motile parasites, helminth eggs, cysts, and oocysts of intestinal protozoa followed by Kato-Katz and formal ether concentration technique[13].

Study variables

Dependent variable: Intestinal parasites status

Independent variable:Socio demographic variables, such asage, sex, monthly income, educational level, service year; Individual factors, such as proper personal hygiene practice, using fresh vegetable salads and meat, use of sanitizer and disinfectants, environmental sanitation, contact with water source, contact with an animal, eating raw meat and vegetables; Economic factors, such asquality of housing, isolation from work environment when sick, lack of supply of safe water, lack of access to toilet facility, lack of medical check screening

Data quality assurance

To assure the data quality, the data collection instrument was pretested in nearby towns. Data collectors weretrained before the actual data collectionperiod by experts from Tigray Health and Research Institute. Furthermore, the collected data were reviewed and checked for completeness each day. Laboratory investigations were done as per the standard operating procedures for specimen collection, transportation, and analysis of fecal specimen.

Data analysis

After checking for completeness, data were coded, cleaned, and enteredintoSPSS version 21.0 for analysis. Binary logistic regression was used to determine the possible associations between the independent variables and an outcome variable.Those factors with a p-value of 0.2 and below during the bivariate logistic regression analysis were considered for multivariate logistic regression to control the confounders. Finally, statistically significant was declared at p-value <0.05 with a 95% confidence interval.

Socio-demographic characteristics

From the total of 422 study participants, 401 wereincluded in this research(giving a 95%response rate.Out of the 401 participants, 377(94.0%) were females and the mean age of all study participants was 28.74 (±SD=4.56).From the total participants, 21(5.2 %) have completed college and above, 78(19.5%) completed secondary school, 273(68.1%) completed primary school, and the remaining 29(7.2%) were unable to read andwrite. The study also showed that212 (52.9%) participants had monthly incomes ofbetween 500 and 900 birrand the remaining 189 (47.1%) participants earned ≥ 1000 birr monthly(Table 1).

Table 1: Socio-demographic characteristics of study participants (n=401) among food handlers in Medebay Zana district (February-March, 2019)

Characters

Category

Frequency

Percent

Sex

Female

Male

377

94.0

6.0

Age

<21

21-30

31-40

>40

254

110

7.0

63.3

27.4

2.2

Religious

Orthodox

Muslim

398

99.3

0.7

Educational level

College and above

Secondary school

Primary school

Unable to read and write

273

5.2

19.5

68.1

7.2

Monthly income

500 - 900 birr

1000 -1500 birr

212

189

52.9

47.1

Service in year

1-5 year

6-9 year

332

82.8

17.2

Hygiene related factors of food handlers

Responses of the study participants showed that 306(76.3%) washed their hands before food preparation, 73(18.2%) washed their hands usually, and 22(5.5%) washed their hands sometimes. Out of the total participants,222(55.4%) washed their hands with soap and water after using the toilet, 378(94.3%) washed their hands after touching dirty materials and different body parts, 180(44.9%) washed their body regularly in their working area, and284(70.8%) participants had renewed their medical certificate every three months(Table S1).

Working area related factors of food handlers

From the total of 401study participants, 386 (96.3%) used private tap water, 349(87%) hada shower facility in their workplace, 287(71.6%) had separate dressing rooms in their working area, 310(77.3%) used water and detergent to clean utensils and drinking cups, and 87(21.7%) cleaned the kitchen floor at least three times per day (Table S2).

Prevalence and type of intestinal parasite

Based on microscopic stool sample examinations, eight species of intestinal parasites were identified with an overall prevalence of 33.2%.From the total species of intestinal parasites detected the most prevalent wasprotozoan 109(81.7%) followed by helminths 24(18.3%)(Table 2).

Table 2: Prevalence and type of intestinal parasites among the positive participants in District Medebay Zana district towns (February-March, 2019)

Parasites category		Number (%)
Protozoan		109(81.7)
	Entamoeba coli	50(37.4)
	Entamoebahistolytica/dispar	24(18)
	Entamoeba hartmanni	18(13.5)
	Giardia lamblia	17(12.8)
Helminths		24(18.3)
	Schistosoma mansoni	8(6.0)
	Hymenolepis nana	7(5.3)
	Entervious vermicularies	6(4.5)
	Taenia species	3(2.3)
Total		133(100%)

Factors associated with the occurrence ofintestinal parasites

The findings from the bivariate analysis showed that 13 variables meet the criteria of p-value < 0.2 to be included for multivariate analysis. From the total of 13 variables that met the criteria only 7 variables were significantly and independently associated with the occurrence of intestinal parasites at a p<0.05 and the 95% confidence interval. The analysis from the multivariate logistic regression showed that food handlers who have the habit of eating raw vegetables and meats were 31.9times more likely to be positive for intestinal parasites compared to their counterparts [AOR=31.92, 95% CI=10.01-101.80]. Additionally, those food handlers that use public tap water were11.5 times more likely to be positive for intestinal parasitescompared with those that used private tap [AOR=11.59, 95% CI=1.73-77.45], food handlers who washed their hands sometimes before food preparationwere 3.25 times more likely to be positive for intestinal parasitescompared to those who washed always[AOR=3.25,95% CI=1.33-7.92]. Those food handlers who washed their hands sometimes by soap and water after visiting the toilet were 3.54 times more likely to be positive for intestinal parasites compared to those washedtheir hands always[AOR=3.54,95% CI=1.72-7.31]. Similarly, food handlers who have no shower facility at workplace were 3.84 times more likely to be positive for intestinal parasites compared to those who have a shower facility [AOR=3.84, 95% CI=1.47-10.26].

Table 3:Factor associated with occurrence of intestinal parasite from the results of bivariate and multivariate logistic regression among the study participant in Medebay Zana district Towns (February-March, 2019)

Variables

Category

Intestinal parasite

COR(CI)

AOR(CI)

No (%)

Yes (%)

What is the source of water in your working area?

Public tap

Private tap

4(26.7%)

264(68.4%)

11(73.3%)

122(31.6%)

5.95(1.86-19.06)

11.59(1.73-77.45)*

How often you wash your hands before food preparation?

Sometimes

Usually

Always

8(36.4%)

34(46.6%)

226(73.9%)

14(63.6%)

39(53.4%)

80(26.1%)

5.95(1.91-5.48)

4.95(1.99-12.22)

3.25(1.33-7.92)*

4.12(1.13-15.05)*

Do you wash your hands by soap and water after visiting toilet?

Sometimes

Usually

Always

6(18.8%)

74(50.3%)

188(84.7%)

26(81.2%)

73(49.7%)

74(15.3%)

5.45(3.34-8.88)

23.96(9.17-62.57)

3.54(1.72-7.31)*

6.05(1.67-21.92)*

Have you use your sick leave properly to obtain treatment?

Yes

56(47.9%)

212(74.6%)

61(52.1%)

72(25.4%)

3.21(2.04-5.03)

Does your workplace have shower facility?

Yes

18(34.6%)

250(71.6%)

34(65.4%)

99(28.4%)

4.77(2.57-8.84)

3.84(1.47-10.26)*

Do you wash your body regularly in your working area?

Yes

116(52.4%)

152(84.4%)

105(47.5%)

28(15.6%)

4.91(3.03-7.95)

2.48(1.09-5.61)*

Do you have habit to eat raw vegetables &meat?

Yes

6(12.8%)

264(74.0%

41(87.2%)

92(26%)

19.46(7.99-47.34)

31.92(10.01-101.80)*

Does your working area have separate dressing room?

Yes

55(48.2%)

213(74.2%)

59(51.8%)

74(25.8%)

3.08(1.96-4.85)

Do you wear clean aprons when you preparing food?

Yes

63(46.0%)

205(77.7%)

74(54%)

59(22.3%)

4.08(2.61-6.36)

Do you wear hair garments during preparing food?

Yes

59948.4%)

209(74.9%)

63(51.6%)

70(25.1%)

3.18(2.04-4.98)

How frequently the kitchen floor cleaned?

(per day)

One times

Two times

Three times

35(30.4%)

152(76.4%)

81(93.1%

80(69.6%)

47(23.6%)

6(6.9%)

30.85(12.30-77.38)

4.17(1.71-10.18)

13.73(4.21-44.77)*

2.51(0.85-7.39)

Monthly income (birr)

500 – 900 1000 – 1500

119(56.1%)

149(78.8%)

93(43.9%)

40(21.2%)

2.91(1.87-4.52)

Note: CI=Confidence interval AOR=Adjusted odds ratio COR=Crude odds ratio * =Significant associated factors

The study researched unaddressed areas in Tigray region and generated new findings with regard to the prevalence of intestinal parasites among food handlers and the potential risk factors. The findings will have paramount importance for the evidence-based interventions that ensure food safety, improve the health of food handlers and the public at large. In this cross-sectional study, the overall prevalence of intestinal parasites among food handlers was 33.2% in Medebay Zana District, North West Tigray. The prevalence of intestinal parasites in this study was relatively higher than the studies reported in Ethiopia, Aksum Town at 14.5%[14], Gondar, Northwest Ethiopiaat 29.1%[15],North EastIndia at 29.33% [16],Saudi Arabiaat 23%[17],Accra, Ghanaat 21.6%[18], Kenyaat23.7%[19],Omdurman, Sudanat 6.9%[20], Turkeyat 8.8%[21], and Sari and Northern Iranat 15.5%[22]. Whereas lower than a study done in South West Ethiopia 44.1%[23], Bahr Dar Town 41.1%[24], Jima Town 48.2%[25], Tigray Mekelle Town 49.3%[26], and India Tertiary Care Hospital 40.5%[27].The prevalence of intestinal parasites in the current study wasconsistent with the studiesconducted in Southern, Ethiopia which was 36% [28] and a study conducted in Qatar reporting 33.9% prevalence[29].

The variability from our current prevalence may reflect differences in socioeconomic status, climatic conditions, poverty, personal and community hygiene, and period of the study. Differences in the study time might have also contributed as our study was conducted during the time when irrigation movement was high; hence,the entire data set was collected during dry months which may contribute to raising the prevalence of schistosomiasis and other helminths. In many arid or semi-arid habitats, some protozoan parasites are common toward the end of the rainy season [20]. The cultural habit of eating raw meat in some areas may contribute to increasing presence o fhelminths[5].

In the present study, many intestinal parasitic infections were found with S. mansoni being the predominant parasite from helminths followed by Hymenolepis nana. This finding was relatively consistent with a similar study conducted in Aksum Town, Ethiopia[14]. Entamoeba coli was the most predominant parasite from protozoan parasites followed by E.histolytica/dispar which resembled findings from a similar study conducted in Southern Ethiopia, reporting the prevalence of (36%) [28].

Poor personal and environmental hygiene, including using public tap water and eating raw vegetables and meat among food handlers is a common practice that contributes to food and water-borne as well as skin transmitted diseases[26]. Parasite eggs in the environment can contaminate water source,vegetables , hands and subsequentlyingested with foods[22]. Hence, in this study,the untrimmed source of water, washing hands before food preparation, washing hands with soap and water after visiting toilet, shower facilities in the workplace, regular washing of one’s body, habit to eat raw vegetables & meat and kitchen floor cleanedwere identified as determinant factors for intestinal parasites among food handlers. In comparison with other studies, poor hand washing practice was similarly found to be a significant predictor of intestinal parasitosis among food handlers in Southwest Ethiopia [7].

In conclusion, this study revealed a high prevalence of intestinal parasite among food handlers who tested positive for different intestinal parasites.Sourceof water, hand washing after visiting the toilet and before food preparation, shower facilities, washing one’s body regularly, practices related to eating raw vegetables and meat, and kitchen floor cleanedwere the identified factors affecting food handlers for the risk of acquiring the intestinal parasite in the study area. Hence, the existing health extension package interventional measures particularly on improving personal hygiene and environmental sanitation should be strengthened and sustained in order to further reduce intestinal parasitic infections among food handlers and the community at large. Comprehensive community-based health education should be given for those food handlers targeting on risk factors of intestinal parasite. Since this study was conducted within single district on limited numbers of participants who were working in food service establishments which mean the findings may not be generalizable to the overall food handlers working in the region. Thus we also recommend researchers to conduct large scale follow up studies in a regional context.

Declarations

Ethics approval and consent to participate: Ethical clearance was obtained from the Ethical Review Board, Institute of Biomedical Science Mekelle University. The respondents were informed about the objective and purpose of the study and written consent was obtained from each respondent. The confidentiality of the information was assured.

Consent for publication: Not applicable

Availability of data and materials: All data generated or analyzed during this study isincluded in this published article.

Competing interests: We, the authors, declare no conflict of interests

Funding: This work was not funded by any external funding agent. Mekelle University College of Health Sciences supported the process of data collection.

Authors’ contribution: KR, KT, GB& MT: Conceived and designed the proposal analyzed the data and wrote the initial version of the manuscript; HG, GG& MT, Wrote the final version of the manuscript. All authors read and approved the final version of the manuscript.

Acknowledgment

We would like to acknowledge the study participants for their willingness to participate in the current study

Wegayehu T, T.T., Seifu B, Teklu T.Prevalence of intestinal parasitic infections among highland and lowland dwellers in Gamo area, South Ethiopia. . BMC Public Health. , 2013; 13(1):151.
World Health Organization.Control of leishmaniasis. Report by the secretariat. 2007.
World Health Organization.Soil-transmitted-helminth Infections. Accessed 28 Apr 2018.
Saboyá MI, C.L., Ault SK, Nicholls RS. , Prevalence and intensity of infection of soil-transmitted helminths in Latin America and the Caribbean countries:Mapping at second administrative level 2000–2010. Pan American Health Organization 2011.
Daryani A, E.G., Sharif M, Ghorbani L, Ziaei H. Prevalence of intestinal parasites in vegetables consumed in Ardabil, Iran. Food Control, 2008;. 19:790-4.
Nyarango RM, A.P., Kadiru EW, Nyanchongi BO.The risk of pathogenic intestinal parasite infections in Kisii Municipality, Kenya. BMC Public Health, 2008; 8:237.
Tefera T, Mebrie G. Prevalence and Predictors of Intestinal Parasites among Food Handlers in Yebu Town, Southwest Ethiopia. PLoS ONE 2014; 9(10): e110621. doi:10.1371/journal.pone.0110621
Deribe K, M.K., Gebre T, Hailu A, Ali A, Aseffa A, et al.The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination. Parasites & Vectors, 2012;. 5(1):240.
Mudey AB, K.N., Mudey GA, Goyal RC, Dawale AK, Wagh VV. Health status and personal hygiene among food handlers working at food establishment around a rural teaching hospital in Wardha District of Maharashtra, India. Global Journal of Health Science. 2010; . 2(2):198.
Arani AS, A.R., Akhlaghi L, Shahi M, Lari AR. Prevalence of intestinal parasites in a population in south of Tehran, Iran. . Rev Inst Med Trop Sao Paulo. , 2008; 50:145-9.
Nigusse D, K.A.Food hygiene practices and prevalence of intestinal parasites among food handlers working in Mekelle university student’s cafeteria, Mekelle. Global Adv Res J Soc Sci (GARJSS). 2012;. 1(4):065-71.
Kidane E, M.S., Kebede A, Desta M. Prevalence of intestinal parasitic infections and their associations with anthropometric measurements of school children in selected primary schools, Wukro Town, Eastern Tigray, Ethiopia. International Journal of Current Microbiology andApploed Sciences,2014; 3(3): 11-29.
Cheesbrough, M. District laboratory practice in tropical countries. Part 2. 2^nd ed. New York: Cambridge University Press; 2006.14.
Gezehegn D, A.M., Tetemke D, Zelealem H, Teklay H, Baraki Z, Medhin G. , Prevalence and factors associated with intestinal parasite among food handlers of food and drinking establishments in Aksum Town Tigray, Ethiopia. 2017,. 17;17(1):819.
Andargie G, K.A., Moges F, Tiruneh M, Huruy K. , Prevalence of bacteria and intestinal parasites among food-handlers in Gondar town, northwest Ethiopia. . J Health Popul Nutr. , 2008;. 26(4):451.
Ghosh A, Mishra PP, Sharma VP. Prevalence of Parasitic Infestations amongst the Food Handlers in a City of North Eastern Region of India. National Journal of Integrated Research in Medicine 2014; 1:5(2).
Zaglool D, O.R., Farooq M., Prevalence of intestinal parasites and bacteria among food handlers in a tertiary care hospital. Nigerian Medical Journal: Journal of the Nigeria Medical Association; 2011. 52(4):266.
Ayeh-Kumi P, Q.S., Kwakye-Nuako G, Kretchy J, Osafo-Kantanka A, Mortu S. , Prevalence of intestinal parasitic infections among food vendors in Accra, Ghana. The Journal of Tropical Medicine and Parasitology. 2009;. 32(1):1-8.
Biwott GK, W.P., Ngeiywa MM., Prevalence of Gastrointestinal Parasitic Infections among Food Handlers in Eldoret Municipality, Kenya. . Journal of Biology, Agriculture and Healthcare. 2014;. 4(27):160-71.
Saeed HA, H.H.Bacteriological and parasitological assessment of food handlers in the Omdurman area of Sudan. Journal of Microbiology, Immunology and Infection. 2010;. 43(1):70-3.
Gunduz T, L.M., Cumen S, Ari A, Etiz S, Tay Z.Prevalence of intestinalparasites and nasal carriage of Staphylococcus areus among food handlersin Manisa Turky. Journal of Environmental Health. 2008;. 18(5):230–5.
Sharif M, D.A., Kia E, Rezaei F, Nasiri M, Nasrolahei M. Prevalence ofintestinal parasites among food handlers of Sari, Northern Iran. Rev Inst MedTrop Sao Paulo. 2015;. 57(2):139–44.
Tefera T, M.G.Prevalence and Predictors of Intestinal Parasites among Food Handlers in Yebu Town, Southwest Ethiopia. PloS One. , 2014; 9(10):e110621.
Abera B, B.F., Bezabih B. Prevalence of Salmonella typhi and intestinal parasites among food handlers in Bahir Dar Town, Northwest Ethiopia. Ethiopian Journal of Health Development., 2010;. 24(1).
Jejaw A, Z.A., Zemene E, Belay T. Status of intestinal parasitic infections among residents of Jimma Town, Ethiopia. . BMC Research Notes., 2014,. 7:502.
Nigusse D, K.A.Food hygiene practices and prevalence of intestinal parasites among food handlers working in Mekelle university student’s cafeteria, Mekelle. Global Adv Res J Soc Sci (GARJSS). 2012;. 1(4):065-71.
Sande S, B.S., Sande V, Tawade V. Screening of Food Handlers for Intestinal Parasites and Enteropathogenic Bacteria in a Tertiary Care Hospital. International Journal of Health Sciences and Research (IJHSR). 2014; 4(5):88-94.
Mama MA, A.G.Prevalence and factors associated with intestinal parasitic infections among food handlers of Southern Ethiopia. BMC Public Health. (2016) 16:105.
Abu-Madi MA, B.J., Ismail A. Patterns of infection with intestinal parasites in Qatar among food handlers and housemaids from different geographical regions of origin. Acta tropica. 2008;. 106(3):213-20.

Table 1: Socio-demographic characteristics of study participants (n=401) among food handlers in Medebay Zana district (February-March, 2019)

Characters

Category

Frequency

Percent

Sex

Female

Male

377

Age

<21

21-30

31-40

>40

254

110

63.3

27.4

2.2

Religious

Orthodox

Muslim

398

99.3

0.7

Educational level

College and above

Secondary school

Primary school

Unable to read and write

273

5.2

19.5

68.1

7.2

Monthly income

500 - 900 birr

1000 -1500 birr

212

189

52.9

47.1

Service in year

1-5 year

6-9 year

332

82.8

17.2

Table 2: Personal hygiene characteristics of study participants (n=401) among food handlers in Medebay Zana district Towns (February-March, 2019).

Characters

Category

Frequency

Percent

How often do you wash your hands before food preparation?

Always

Usually

Sometimes

306

76.3

18.2

5.5

Do you wash your hands by soap and water after visiting toilet?

Always

Usually

Sometimes

222

147

55.4

36.7

Do you wash your hands after touching dirty materials and different body parts?

Yes

378

5.7

94.3

Do you wash your body regularly in your working area?

Yes

221

180

55.1

44.9

Do you have a medical checkup certificate?

Yes

401

100

How frequent do you come to health center for medical checkup?

Every three month

Every six month

Every nine month

284

70.8

17.5

11.7

Do you wear clean aprons during food preparation?

Yes

137

264

34.2

65.8

Do you wear clean hair garment during food preparation?

Yes

122

279

30.4

69.5

How frequent do you cut your fingernails?

Two times per week

One times per week

One times per two week

295

7.2

18.2

74.1

Table 3: Working area related factors of food handlers (n =401) in Medebay Zana district Towns (February-March, 2019)

Variables

Category

Frequency

Percent

What is the source of water in your working area?

Private tap

Public tap

386

96.3

3.7

Does your working area have shower facility?

Yes

349

Does your working area have separate dressing room?

Yes

114

287

28.4

71.6

What do you use to clean utensils and drinking cup?

Only water

Water and detergent

Hot water and detergent

310

13.2

77.3

9.5

How frequently is the kitchen floor cleaned?

One times per day

Two times per day

Three times per day

115

199

28.7

49.6

21.7

Do you have toilet facility in your working area?

Yes

401

100

Table 4: Prevalence and type of intestinal parasites among the positive participants in District Medebay Zana district towns (February-March, 2019)

Parasites category			Number (%)
Protozoan			109(81.7)
		Entamoeba coli	50(37.4)
		Entamoeba histolytica/dispar	24(18)
		Entamoeba hartmanni	18(13.5)
		Giardia lamblia	17(12.8)
Helminths			24(18.3)
	Schistosoma mansoni		8(6)
	Hymenolepis nana		7(5.3)
	Enterviousvermicularies		6(4.5)
	Taenia species		3(2.3)
Total			133(100%)

Table 5: Factor associated with occurrence of intestinal parasite from the results of bivariate and multivariate logistic regression among the study participant in Medebay Zana district Towns (February-March, 2019)

Variables

Category

Intestinal parasite

COR(CI)

AOR(CI)

No (%)

Yes (%)

What is the source of water in your working area?

Public tap

Private tap

4(26.7%)

264(68.4%)

11(73.3%)

122(31.6%)

5.95(1.86-19.06)

11.59(1.73-77.45)*

How often you wash your hands before food preparation?

Sometimes

Usually

Always

8(36.4%)

34(46.6%)

226(73.9%)

14(63.6%)

39(53.4%)

80(26.1%)

5.95(1.91-5.48)

4.95(1.99-12.22)

3.25(1.33-7.92)*

4.12(1.13-15.05)*

Do you wash your hands by soap and water after visiting toilet?

Sometimes

Usually

Always

6(18.8%)

74(50.3%)

188(84.7%)

26(81.2%)

73(49.7%)

74(15.3%)

5.45(3.34-8.88)

23.96(9.17-62.57)

3.54(1.72-7.31)*

6.05(1.67-21.92)*

Have you use your sick leave properly to obtain treatment?

Yes

56(47.9%)

212(74.6%)

61(52.1%)

72(25.4%)

3.21(2.04-5.03)

Does your workplace have shower facility?

Yes

18(34.6%)

250(71.6%)

34(65.4%)

99(28.4%)

4.77(2.57-8.84)

3.84(1.47-10.26)*

Do you wash your body regularly in your working area?

Yes

116(52.4%)

152(84.4%)

105(47.5%)

28(15.6%)

4.91(3.03-7.95)

2.48(1.09-5.61)*

Do you have habit to eat raw vegetables &meat?

Yes

6(12.8%)

264(74%

41(87.2%)

92(26%)

19.46(7.99-47.34)

31.92(10.01-101.80)*

Does your working area have separate dressing room?

Yes

55(48.2%)

213(74.2%)

59(51.8%)

74(25.8%)

3.08(1.96-4.85)

Do you wear clean aprons when you preparing food?

Yes

63(46%)

205(77.7%)

74(54%)

59(22.3%)

4.08(2.61-6.36)

Do you wear hair garments during preparing food?

Yes

59948.4%)

209(74.9%)

63(51.6%)

70(25.1%)

3.18(2.04-4.98)

How frequent you cut your fingernails?

(per week)

One times

One times Two times

184(62%)

62(82.7%)

22(75.9%)

113(38%)

13(17.3%)

7(24.1%)

1.93(0.79-4.66)

0.65(0.23-1.86)

How frequently the kitchen floor cleaned?

(per day)

One times

Two times

Three times

35(30.4%)

152(76.4%)

81(93.1%

80(69.6%)

47(23.6%)

6(6.9%)

30.85(12.30-77.38)

4.17(1.71-10.18)

13.73(4.21-44.77)*

2.51(0.85-7.39)

Monthly income (birr)

500 – 900 1000 – 1500

119(56.1%)

149(78.8%)

93(43.9%)

40(21.2%)

2.91(1.87-4.52)

Note: CI=Confidence interval AOR=Adjusted odds ratio COR=Crude odds ratio * =Significant associated factors

Download PDF

Journal Publication

published 31 Jan, 2021

Read the published version in Tropical Diseases, Travel Medicine and Vaccines →

Editorial decision: Minor revision
24 Sep, 2020
Review #2 received at journal
04 Sep, 2020
Reviewer #2 agreed at journal
18 Aug, 2020
Reviewer #1 agreed at journal
17 Aug, 2020
Review #1 received at journal
17 Aug, 2020
Reviewers invited by journal
16 Aug, 2020
Editor assigned by journal
04 Aug, 2020
Submission checks completed at journal
03 Aug, 2020
Editor invited by journal
03 Aug, 2020

You are reading this older preprint version

Read the latest preprint version →

Prevalence and factors associated with intestinal parasites among food handlers in Medebay Zana District, North West Tigray, Northern Ethiopia.

Status:

Journal Publication

Version 3

Abstract

Introduction

Methods And Materials

Study area, design and period

Population

Sample size and sampling technique

Data collectiontools

Data quality assurance

Data analysis

Result

Socio-demographic characteristics

Hygiene related factors of food handlers

Working area related factors of food handlers

Prevalence and type of intestinal parasite

Factors associated with the occurrence ofintestinal parasites

Discussion

Conclusion

Declarations

References

Tables

Supplementary Files

Status:

Journal Publication

Version 3