Food Hygiene

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Preventive Strategy Against Infectious Diarrhea – A Holistic Approach

Motarjemi M, Steffen R, Binder HJ (2012) Gastroenterology, 143:516-519

This Comment from the Editor calls for an integrated strategy involving an interdisciplinary and mutlisector approach by world public health authorities, including WHO and UNICEF, to combat diarrheal disease morbidity through their policy and field interventions that explicitly acknowledges the role food safety in presenting such diseases.  The authors note that education is a central point of all interventions, be it through awareness campaign (e.g. the WHO Five Keys to Safer Food), training of health professionals on the job, and/or education of medication and public health students.

Global burden of human food-borne trematodiasis: a systematic review and meta-analysis

Furst T, Keise, J and Utzinger J. The Lancet Infectious Diseases, 12(3): 210 – 221, March 2012
doi:10.1016/S1473-3099(11)70294-8
Published Online: 21 November 2011
Summary

Background
Food-borne trematodiases are a group of neglected tropical diseases caused by liver, lung, and intestinal parasitic fluke infections. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2010 study) and a WHO initiative, we assessed the global burden of human food-borne trematodiasis, as expressed in disability-adjusted life years (DALYs) for the year 2005.
Methods
We systematically searched electronic databases for reports about human food-borne trematodiasis without language restriction, between Jan 1, 1980, and Dec 31, 2008. We used a broad search strategy with a combination of search terms and parasite and disease names. The initial search results were then screened on the basis of title, abstract, and, finally, full text. Relevant quantitative and qualitative data on human prevalence, morbidity, and mortality of food-borne trematodiasis were extracted. On the basis of available information on pathological and clinical appearance, we developed simplified disease models and did meta-analyses on the proportions and odds ratios of specified sequelae and estimated the global burden of human food-borne trematodiasis.
Findings
We screened 33 921 articles and identified 181 eligible studies containing quantitative information for inclusion in the meta-analyses. About 56·2 million people were infected with food-borne trematodes in 2005: 7·9 million had severe sequelae and 7158 died, most from cholangiocarcinoma and cerebral infection. Taken together, we estimate that the global burden of food-borne trematodiasis was 665 352 DALYs (lower estimate 479 496 DALYs; upper estimate 859 051 DALYs). Furthermore, knowledge gaps in crucial epidemiological disease parameters and methodological features for estimating the global burden of parasitic diseases that are characterised by highly focal spatial occurrence and scarce and patchy information were highlighted.
Interpretation
Despite making conservative estimates, we found that food-borne trematodiases are an important cluster of neglected diseases.
Funding
Swiss National Science Foundation; Institute for Health Metrics and Evaluation.

Written by geraldmoy

March 21, 2012 at 4:57 am

Five Keys to Safer Foods – country examples

http://www.who.int/foodsafety/consumer/5keys/en/index1.html

 

WHO aims to improve the exchange and reapplication of practical food safety knowledge in and between Member States. Countries can highly benefit by exchanging experiences and tested solutions with each other. This section will enable countries and partners to have access to the different tools produced in different parts of the world to deliver the Five Keys messages.

The Five Keys poster has been translated into over 70 languages and training materials for various target groups, especially school children, have been prepared.

Community-Based Intervention Study of Food Safety Practices in Rural Community Households of Cambodia

Ms Frances Warnock, WHO Consultant Food Safety Education
Submitted 3 December 2007, http://www.who.int/foodsafety/consumer/Cambodia_Dec07.pdf

Between July 2007 and November 2007 the writer undertook three Missions to Cambodia
to provide technical assistance and support to the National Centre for Health Promotion
(NCHP) Cambodia in conducting a community-based food safety intervention study
involving rural community households. The project built upon earlier work conducting
food safety training workshops for forty Village Health Support Group (VHSG)
volunteer health workers from the Provinces of Kampong Chnnang and Kampong Thom.
The current project, which was conducted over five months and in three phases, made
further progress towards gaining a sound understanding of high risk food handling
practices in rural households. Information gathered from a baseline study engaging
VHSG volunteers to observe food safety practices in 200 rural households in villages of
Kampong Chnnang and Kampong Thom, formed the basis for developing an evidenced based
approach to food safety education aimed at behaviour change.
Specific activities included: training workshops followed by observation of household
food safety practices and completing a food safety checklist tool (baseline assessment and
final evaluation); taking time-temperature measurements of selected high risk
foods/dishes; using baseline assessment to develop key food safety messages and produce
a food safety information poster specifically targeting rural households; dissemination of
information materials by VHSG volunteers to rural village households and conducting
small group education sessions aimed at changing high risk food safety behaviours; and
focus group feedback workshops with VHSG volunteers to assist with identifying factors
that contributed to (enablers), or hindered (barriers) behaviour modification.
The model process developed in this study for food safety education in rural communities
of Cambodia involving: (1) Mobilization of VHSG volunteers to conduct education in
their villages; and (2) Providing the new food safety information poster targeting rural
households (modified WHO Five Keys to Safer Food messages); proved to be highly
effective in improving household food safety practices. It is strongly recommended that
this model process for food safety education in rural communities be adopted throughout
Cambodia. Adequate financial resources are required to continue and expand this
important work. It is recommended that funding be sought from both Government and
International Agencies to ensure food safety education in rural communities is given
priority it rightly deserves.
Through sustained effort and action at the grassroots level in rural communities, there is
potential to mobilize community action and improve household food safety practices,
thereby reducing the burden of foodborne illness in Cambodia.
“There is a wealth of messengers in communities with the power to draw attention and
foster a supportive environment. When used with the mass media these voices can put
healthy behaviour on the national public agenda”. (Source: Mobilizing For Healthy
Behaviour, WHO 2002).

Written by geraldmoy

February 12, 2012 at 4:05 pm

Community-Based Intervention Study of Food Safety Practices in Rural Community Households of Lao PDR

Warnock F.  WHO Regional Office for the Western Pacific, Manila http://www.who.int/foodsafety/consumer/Laos_Dec07.pdf (2007)

Between July 2007 and December 2007 the writer undertook three missions to Lao PDR to provide technical assistance and support to food safety personnel in the Department of Food and Drugs (FDD), Ministry of Health Laos, to conduct a community-based food safety intervention study in rural communities. The project built upon earlier work conducting food safety training workshops for Lao Women Union representatives from Phonehong District, Vientiane Province.

The current project, which was conducted over five months and in three phases, made further progress towards gaining a sound understanding of high risk food handling practices in rural households. Information gathered from a baseline study engaging Lao Women to observe food safety practices in 180 village households in Phonehong District formed the basis for developing an evidenced-based approach to food safety education aimed at behaviour change.

Specific activities included: training workshops followed by observation of household food safety practices and completing a food safety checklist tool (baseline assessment and final evaluation); taking time-temperature measurements of selected high risk foods/dishes; using the baseline assessment to develop key food safety messages and produce a food safety information poster specifically targeting rural households; dissemination of information materials to rural village households and Lao Women conducting small group education sessions; and a focus group feedback workshop with Lao Women and FDD to explore next steps in progressing this activity.

This food safety intervention study in rural households in Phonehong District has led to a better understanding of high risk food safety practices, and in particular, identified the consumption of raw meats and raw fish products to be a common practice among rural people and a significant problem. It has highlighted the importance of adopting an evidence-based approach to food safety education and not simply adapt/ translate existing information materials. Culture and traditional habits must be considered in food safety education programs if there is to be any impact on changing behaviours.
Involvement of the Lao Women’s Union as a key partner to provide food safety education in rural communities, with training and technical support provided by FDD, has demonstrated to be quite a successful model. It is recommended that this collaborative approach continue and the education activity expanded to other Provinces of Lao PDR in 2008.

It is recognised that broad behavioural change requires years of consistent effort to achieve. But through sustained effort and action at the grassroots level in rural communities there is potential to mobilize community action and improve household food safety practices, thereby reducing the burden of foodborne illness in Lao PDR.

Financial resources are required to support this important food safety education work, and it recommended that funding be sought from the Government and International Agencies to ensure this important work continues in rural communities of Laos.

Written by geraldmoy

February 10, 2012 at 10:07 am

Microbial Contamination of Seven Major Weaning Foods in Nigeria

 

Oluwafemi F and  Nnanna Ibeh I. J Health Popul Nutr. 29(4): 415–419 (2011)

 

Five million children aged less than five years die annually due to diarrhoea. The aim of the study was to identify some possible contributing factors for persistent diarrhoea. Seven weaning foods, including a locally-made food, were evaluated by estimating the microbial load using the most probable number method and aflatoxin levels (AFM1, AFG1, AFG2, and AFB2) by immunoaffinity column extraction and high-performance liquid chromatography (HPLC) with detection of fluorescence.

The results showed that the locally-made weaning food had the highest microbial count (2,000 cfu/g) and faecal streptococcal count (25 cfu/g). Moulds isolated were mainly Aspergillus niger, A. flavus, A. glaucus, Cladosporium sp., and Penicillium sp. The home-made weaning food recorded the highest fungal count (6,500 cfu/g). AFM1 of the weaning foods was 4.6-530 ng/mL. One weaning food had AFB1 level of 4,806 ng/g. Aflatoxin metabolites, apart from AFM1 and AFB1 present in the weaning foods, were AFG1 and AFG2. There were low microbial counts in commercial weaning foods but had high levels of aflatoxins (AFM1, AFG1, AFG2, AFB1, and AFB2).

Growth and development of the infant is rapid, and it is, thus, possible that exposure to aflatoxins in weaning foods might have significant health effects.

Written by geraldmoy

February 7, 2012 at 3:02 pm

Critical control points for foods prepared in households in which babies had salmonellosis

Michanie S Bryan FL Alvarez P Olivo AB.  Int J Food Microbiol. 5:337-354 (1987)

 

Sixteen babies undergoing reehydration therapy were examined for enteric pathogens.  Salmonella agona was isolated from four, Samonella enteritidis from two, Shiegella boydii from one: neither Campylobacter nor Yersinia were recovered from any of the babies.  Three househoolds in which Samonella group B (S. aghona) was isolated from the babies were selected for hazard analysis of food preparation practices.  In one house, S. agona was recovered from the feces of the mother and gransmother of the baby and from a kitchen knife, a blender, malagueta (spice) used to flavor milk, a mop and flies.  All foods were cooked to 100 C and many were eaten a short time afterwards.  Some foods were held at ambient room temperature until the arrival of an absent family member or kept overnight.  During the holding interval, large numbers of microorganism accumulated in the foods, often exceeding 10, 000,000/gh. Bacillus cereus was recovered from 7 of 16 samples of cooked foods.  The sample of  “moro” (rice and beans mixture) had a count of 1,500,000/g.  Staphyl9ococcus aureus was isloated for 11 smaples; a sample of milk had a count of great than 100,000/g.  Critical control points for milk formula were heating, holding after heating, cleaning and disinfecting bottles, nipples and pans used to store milk, and utensils used to dispense the milk.