Socio-demographic factors and availability of piped fountains affect food hygiene practice of food handlers in Bahir Dar Town, northwest Ethiopia: a cross-sectional study.

BACKGROUND: Morbidity and mortality rates of food borne diseases are consistently highest in African due to poor food handling and sanitation practices. Thus, the study aimed to assess food handling practice and associated factors among food handlers of Restaurants in Bahir Dar Town, northwest, Ethiopia. A cross-sectional study was conducted from December, 7/2012 to January, 2/2013 among food handlers working in 106 restaurants in Bahir Dar Town. A structured questionnaire composed of socio-demographic factors, food safety knowledge, working environmental characteristics and food hygiene practice of food handlers was employed to collect the data via interviewing and observations. Binary logistic regression model was fitted to assess factors associated with food hygiene practice after multi-collinearity and outlier were checked and data was clean. Both crude odds ratio (COR) and adjusted odds ratio (AOR) were estimated to show the strength of association. In multivariate analysis, variables with a P value of ≤ 0.05 were considered as statistical significant. RESULTS: About 67.6% [95% confidence interval (CI) 58.8, 76.4] of food handlers had good food hygiene practice, whereas 32.4% of food handlers had poor food hygiene practice. The odds of having good food hygiene practice was higher among food handlers who had received food safety training [AOR: 4.7, 95% CI 1.7, 12.8], had formal education [AOR: 6.4, 95% CI 3.5, 11.5] and work experiences greater than 2 years [AOR: 3.4, 95% CI 1.8, 6.4]. At last, food handlers working in restaurants which had piped fountains for hand wash were 2.1 times more likely to have good food hygiene practice[AOR: 2.1, 95% CI 1.1, 3.8]. CONCLUSION: In this study, the overall food hygiene practice of food handlers is not to the acceptable level. Therefore, endeavors ought to be reinforced to improve food hygiene practices of food handlers through intervention programs such as training and education. Also emphasis should be given on the accessibility of piped fountains for the better food handling practice of food handlers.

Multidrug resistant tuberculosis in Ethiopian settings and its association with previous history of anti-tuberculosis treatment: a systematic review and meta-analysis.

BACKGROUND: Efforts to control the global burden of tuberculosis (TB) have been jeopardized by the rapid evolution of multi-drug resistant Mycobacterium tuberculosis (MTB), which is resistant to at least isoniazid and rifampicin. Previous studies have documented variable prevalences of multidrug-resistant tuberculosis (MDR-TB) and its risk factors in Ethiopia. Therefore, this meta-analysis is aimed, firstly, to determine the pooled prevalence of MDR-TB among newly diagnosed and previously treated TB cases, and secondly, to measure the association between MDR-TB and a history of previous anti-TB drugs treatment. METHODS: PubMed, Embase and Google Scholar databases were searched. Studies that reported a prevalence of MDR-TB among new and previously treated TB patients were selected. Studies or surveys conducted at national or sub-national level, with reported MDR-TB prevalence or sufficient data to calculate prevalence were considered for the analysis. Two authors searched and reviewed the studies for eligibility and extracted the data in pre-defined forms. Forest plots of all prevalence estimates were performed and summary estimates were also calculated using random effects models. Associations between previous TB treatment and MDR-MTB infection were examined through subgroup analyses stratified by new and previously treated patients. RESULTS: We identified 16 suitable studies and found an overall prevalence of MDR-TB among newly diagnosed and previously treated TB patients to be 2% (95% CI 1% - 2%) and 15% (95% CI 12% - 17%), respectively. The observed difference was statistically significant (P < 0.001) and there was an odds ratio of 8.1 (95% CI 7.5-8.7) for previously treated TB patients to develop a MDR-MTB infection compared to newly diagnosed cases. For the past 10 years (2006 to 2014) the overall MDR-TB prevalence showed a stable time trend. CONCLUSIONS: The burden of MDR-TB remains high in Ethiopian settings, especially in previously treated TB cases. Previous TB treatment was the most powerful predictor for MDR-MTB infection. Strict compliance with anti-TB regimens and improving case detection rate are the necessary steps to tackle the problem in Ethiopia.