Factors Associated With Intestinal Parasitic Infections among Food Handlers in Selected Eateries in Nairobi County, Kenya

Abstract

Intestinal parasitic infections are major public health problems of majorly among children contributed in part by the adults in developing countries. Food handlers play a critical role in the spread of disease globally. Food contamination may occur at any of the stages including; production, processing, distribution, and preparation. The risk of food contamination therefore depends largely on the health status of the food handlers, their personal hygiene, knowledge and practice of food hygiene. This cross-sectional study was nested within the KEMRI routine medical examination and certification of food handlers from various eateries and food industries in Nairobi Kenya between 2015 and 2016. Structured questionnaire was used to collect socio demographic data and associated risk factors. Stool samples were collected and examined for intestinal parasites using single Kato-Katz and single Sodium acetate-acetic acid-formalin (SAF) solution concentration methods. A total of 298 food handlers were enrolled in the study. The majority of study participants were males (58.4%), aged between 21 to 30 years (59.4%), had secondary level of education (41.6%), 46% were currently married, had between 1 to 3 children (74.6%) and used piped water for domestic purposes (68.1%). About 43 (14.4%) of food handlers were found to be positive for different intestinal parasites with the most abundant parasite of Entameoba histolytica 30 (69.8%) followed by Iodamoeba butschlii 7(16.3%), Giardia lamblia 4 (9.3%), Endolimax nana 1 (2.3%) and Trichomonas hominis 1 (2.3%). Consumption of borehole water (OR 2.2, 95% CI 1.2 to 4.1) and general personal hygienic characteristics such as hand washing before eating (OR 0.5, 95% CI 0.2 to 0.9), after using toilet (OR 0.1, 95% CI 0.02 to 0.5), cooking (OR 0.1, 95% CI 0.02 to 0.6) and wearing of protective gears (OR 1.7, 95% CI 1.1 to 6.4) were associated with intestinal parasitic infection. The present study revealed a high prevalence of intestinal parasite in asymptomatic (apparently healthy) food handlers working in various eateries and food industries in Nairobi Kenya and that water quality and personal hygiene contribute significantly to parasitic infection. Such infected food handlers can contaminate food, drinks and could serve as a source of infection to consumers via food chain.