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ORIGINAL RESEARCH

Food Safety Knowledge, Handling Practices and

Associated Factors Among Food Handlers
Working in Food Establishments in Debre Markos
Risk Management and Healthcare Policy downloaded from https://www.dovepress.com/ on 05-Dec-2023

Town, Northwest Ethiopia, 2020:

Institution-Based Cross-Sectional Study
This article was published in the following Dove Press journal:
Risk Management and Healthcare Policy
For personal use only.

Tadege Alemayehu 1 Purpose: Foodborne illness is a major public health problem worldwide. The supply of safe
Zewdie Aderaw 2 and healthy food is crucial to prevent foodborne illness. However, evidence regarding food
Mastewal Giza 3 safety knowledge and handling practice is limited in Ethiopia. Therefore, this study aimed to
Gedefaw Diress 3 assess food safety knowledge, handling practice, and its associated factors among food
handlers in Debre Markos Town, North West Ethiopia.
1
East Gojjam Zone Health Department,
Patients and Methods: An institutional-based cross-sectional study was conducted on 408
Debre Markos, Ethiopia; 2Public Health
Department, College of Medicine and randomly selected food handlers at Debre-Markos town. A structured questionnaire and an
Health Science, Debre Markos University, observational checklist were used to collect relevant data. The main outcome of interest was
Debre Markos, Ethiopia; 3Public Health
Department, College of Health Sciences, food safety and handling practice. Multivariable logistic regression analysis was used to
Woldia University, Woldia, Ethiopia identify the factors significantly associated with food safety knowledge and food handling
practice. Data were analyzed using SPSS version 25.
Results: In this study, only 34.1% of food handlers had good food safety knowledge and
nearly 54% of food handlers had good food handling practice. Level of education (AOR =
0.23 (0.14–0.57)), training on food safety (AOR = 5.13 (3.57–7.82)), and favorable attitudes
towards food safety (AOR=2.54 (1.52–4.25)) were the factors associated with knowledge of
food safety. Similarly, training (AOR=2.05, 95% CI=1.31–3.19), a good level of knowledge
(AOR: 1.68, 95% CI: 1.40, 3.17), and work experience (AOR = 1.24, 95% CI: 1.10–2.81)
were positively associated with good food handling practice.
Conclusion: In this study, the level of food safety knowledge and handling practices were
relatively low. Therefore, the concerned bodies should work on the identified factors to
improve food handlers’ knowledge of food safety and practice level. Continuous training for
food handlers should be given.
Keywords: knowledge, practice, food safety, food establishment, Ethiopia

Introduction
Now a day’s food safety is the primary public health concern for many countries.
According to World Health Organization (WHO), food safety is defined as the
Correspondence: Gedefaw Diress conditions and measures that are necessary during the production, processing,
PO box: 400 storage, distribution, and preparation of food to ensure that it is safe, sound, and
Tel +251913756945
Email [email protected] wholesome, and fit for human consumption.1–3 Food safety is essential to prevent

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foodborne illness and enhance the well-being of humans.4 32.5% in Arbaminch, South Ethiopia,21 and 52.4% in
Globally, foodborne related illnesses have increased over Diredawa, East Ethiopia.22 Additionally, there are lim­
the years and negatively affected the health and economic ited studies that used observation to investigate food
well-being of many developing and developed countries.5 handling practices. The majority of previous studies
Nowadays, lack of food safety measures is a major public used self-reported practices which may introduce bias
health problem in many parts of the world.6,7 in the study findings.
There is growing evidence that food safety has been Therefore, in countries like Ethiopia, assessing food
neglected in developing countries.8 In developing coun­ handlers’ level of food safety knowledge, handling prac­
tries, particularly in Africa, foodborne diseases may be an tices and its determinants enable regulatory authorities to
important contributor to gastrointestinal disease, and poor take evidence derived measures toward the provision of
hygienic practices during food preparation, handling, and safe food to the consumer. Such studies will also offer
storage are one of the commonest causes of morbidity.5,8 a well understanding of the relations of essential food
In Sub-Saharan Africa, evidence indicates that morbidity safety knowledge, attitudes, and practices of food hand­
and mortality related to lack of food safety are a constant lers. Besides, there is no available evidence on the knowl­
threat to public health organizations.9,10 In Malaysia, by edge and practice of food handlers in food establishments
2014, more than 50% of the total food poisoning cases in the northwest region of Ethiopia, particularly in Debre
were attributed to improper food handling by food Markos town. Therefore, this study aimed to assess food
handlers.11 safety knowledge, attitude, handling practice, and its asso­
In Ethiopia, around 70% of diarrheal disease is asso­ ciated factors among food handlers of food establishments
ciated with the consumption of contaminated food.12 in Debre Markos Town, North West Ethiopia.
Approximately 10 to 20% of food-borne disease outbreaks
are due to contamination by the food handler.13 The
Patients and Methods
Federal Ministry of Health of Ethiopia acknowledges the
depth of the problem by stating that communicable dis­
Study Design, Period, and Setting
An institution-based cross-sectional study was conducted
eases, particularly diarrheal diseases and intestinal para­
in Debre Markos town from September 2019 to
sites, are the leading causes for outpatient attendance and
October 2019. Debre Markos town is found in the
causes of hospitalization most of which are attributed to
Northwest of Ethiopia and located between 10°17′00′′ to
poor food safety. Furthermore, many reported cases of
10°21′30′′ N Latitudes and 37°42′00′′ to 37°45′30′′
food-borne viral diseases have been attributed to infected
E longitude. It is 300 Kilometers far from Addis Ababa
food-handlers involved in catering services.14,15
(the capital city of Ethiopia) and 265 Kilometers from
In Ethiopia, particularly in urban settings, eating and
Bahir Dar (the capital of Amhara National Regional
drinking in food establishments (hotels, restaurants, and
State). The town consists of 11 Keble’s with 125,636
snack bars) is common. These food establishments pre­
projected populations from the 2008 census; of which
pare, handle, and serve large quantities of food to large
66,832 are female and 58,804 male. There are 147 food
groups of people within a short period of time and imply­
establishments in the town with 3123 food handlers cur­
ing a possible risk of contamination. Food handlers seem
rently working in food establishments.23
to be a major source and means of food contamination.4
Assessing and improving food-handlers knowledge
on food safety and handling practice play a dominant Population and Eligibility Criteria
role in ensuring strict adherence to food safety princi­ The source populations were all food handlers working in
ples. Several cross-sectional studies on food safety food establishments of Debre Markos Town. The study
knowledge and practices of food-handlers were con­ populations were food handlers currently working in
ducted in the country.16–19 However, there is substantial selected food establishments in Debre Markos Town.
heterogeneity in their finding. The magnitude of good Food handlers age ≥14—65 years working in preparation,
food safety knowledge varied from 24.5% in Godey cleaning and service areas of food establishments at the
Town, East Ethiopia20 to 75.9% in Debarq Town, time of the study regardless of their sex and employment
Northwest Ethiopia.16 Similarly, the magnitude of good status were included in the study. However, Food handlers
food handling practice varied across the countries; generally those who cannot answer due to serious illness

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(rather than food-related) at the time of intervention were handlers that obtained a total score ≥ mean (4.82) were
excluded from the study. considered to have “Good knowledge” and those that had
scores < mean were considered to have “Insufficient
Sample Size and Sampling Procedure knowledge”28
The required sample size was determined by using a single The attitude of food handlers’ towards food safety was
population proportion formula with the following assump­ measured using 5 questions that required five Likert scales
tion: 95% CI, 5% margin of error, and 80% power. We response (1=strongly disagree, 2=disagree, 3=neutral, 4
tried to calculate the sample size for each main objective =agree and 5=strongly agree). The scores for attitude were
by taking a proportion of good knowledge on food safety normally distributed. Therefore, we add all scores together
90%, favorable attitude 93%, and good food handling and divide by the number of scores to obtain the mean.
practice 40.1% from previous studies.18,24 Finally, by con­ Finally, food-handlers that answered ≥ mean (13.17) cor­
sidering 10% for non-response rate the required sample rectly were measured to have a “favorable attitude”, whereas
size is found to be 408. those that responded < mean statements/questions correctly
The list of existing food establishments and the number were measured to have an “unfavorable attitude”29
of food handlers currently working in food establishments Food handling practice was assessed by using an obser­
was obtained from the Federal Democratic Republic of vational checklist during serving (working). These prac­
Ethiopia private employee social security agency Debre- tices were also scored and one mark was given for every
Markos branch. Based on social security agency data, in standard practice and zero for every unhygienic practice.
2019, there are 147 food establishments and 3123 food Food-handlers that obtained total score ≥ mean were con­
handlers in Debre Markos town. Initially, of a total of 147 sidered to have “safe practice” and those that had scores <
food establishments, we randomly selected 44 food estab­ mean were considered to have “unsafe practice” (20).
lishments. Study participants were proportionately allo­ The data were collected by four diploma nurses and the
cated to each selected food establishment based on the overall data collection processes were supervised by two
number of food handlers. Then, the sampling frame was environmental health professionals after two-days of train­
prepared for each selected food establishment using the ing. A pre-test was done on 5% of the sample in
updated list of food handlers. Finally, study participants Dembecha town. Accordingly, all the necessary modifica­
were selected using a simple random method (computer- tions were made.
generated) from each establishment.
Data Processing and Analysis
Data Collection Tools and Procedures The data were entered into Epi data version 4.3 and
Data were collected using a structured standard question­ transported to SPSS version 25.0 for further analysis.
naire and an observational checklist. A questionnaire con­ The results were presented in tables and texts using
sisting of close-ended questions pertaining to knowledge descriptive statistics such as mean, standard deviation
on food safety, attitude, and observed practices on food and percentage to describe the study population in relation
safety. The questioner was adapted and modified from to relevant variables. Multivariable logistic regressions
previously published studies.2,15,25–27 The questionnaire were employed to identify the independent factors asso­
was structured into four distinctive parts; demographic ciated with knowledge and practice of food safety. The
(11 questions), knowledge (9 questions), attitude (5 state­ strength of the association between independent variables
ments), and practices (18 statements). and outcome variables was measured using an odds ratio
Food safety knowledge was assessed using 9 closed- (OR) with a 95% confidence interval. All variables with
ended questions with two possible answers; “yes” or “No”. a p-value <0.25 at bivariable logistic regression analysis
The questions mainly focus on the personal hygiene of were included in the final regression model. In multivari­
food handlers, temperature control, cross-contamination, able logistic regression analysis variables with a p-value
food storage, and equipment hygiene. In assessing knowl­ <0.05 were used to declare statistical significant associa­
edge, one point was given for every correct answer and tion. To measure internal consistency, Cronbach’s Alpha
zero points for incorrect answers or unanswered questions. was done for both knowledge and attitude items of ques­
Then, the responses to these questions were added together tions. Cronbach’s Alpha was 0.773 for knowledge and
to generate a knowledge score ranging from 0 to 9. Food- 0.758 for attitude measurement.

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Operational Definitions Characteristics of Food Establishments

Food safety: is the assurance that food would not cause In this study, food handlers were selected from 44 food
any harm to the consumers when it is prepared and/or establishments. All food establishments had private pipe
consumed according to its intended use.15 water and toilet within the establishment. Out of 44 food
Food handler- Person who contact directly with food, establishments, 27 (61.4%) had disposed of liquid waste
or with any equipment or utensil used in food handling. into a latrine and 2 food establishments dispose liquid
Food establishment-establishments engaged in the wastes into open space (Table 2).
work of providing food and drink services to large groups
of customers in the form of breakfast, lunch, dinner, or Food Safety Knowledge and Handling
drinks. These establishments are hotels, restaurants, cafe­ Practice
terias, and snack houses.30 From the total participants, nearly half of the participants
(52.2%) responded that contaminated foods always have
some change in color, odor, or taste. Similarly, 45.6% of
Results
food handlers responded that cooked foods do not have
Socio-Demographic Characteristics of microbes. Of the total food handlers, 157 (38.5%)
Study Participants responded that use of jewels such as rings, watches, wear­
In this study, a total of 408 study participants partici­ ing in food handling cause food contamination. Overall,
pated with a response rate of 100%. Out of the total only 34.1% (n=139) of food handlers had adequate knowl­
participants, 56.3% were female and almost all (99.8%) edge of food safety. The majority (65.9%) of food handlers
of food handlers were Orthodox Christian religious had inadequate knowledge. More than three-fourths
followers. The mean age of respondents was 22.5 (74.6%) of food handlers had a favorable attitude towards
years (SD± 3.55). More than three-fourths (75.7%) of food safety but only 53.7% of food handlers had good
the respondents were single and nearly two-thirds have handling practice (Table 3).
completed secondary education. The majority of food
handlers (84.3%) did not receive any training on food Factors Associated with Food Safety
safety (Table 1). Knowledge
During bivariable regression analysis, levels of education,
sex, length of employment, and attitude of the respondents
Table 1 Socio-Demographic Characteristics of Food Handlers
were significantly associated with food safety knowledge.
Working in Food Establishments in Debre Markos Town, In the final regression model, level of education, training
October 2019 (n=408)
Variables Category Frequency Percentage Table 2 Institutional Characteristics of Food Establishments in
Debre Markos Town, Northwest Ethiopia, 2019 (n = 44)
Sex Male 177 43.3
Female 231 56.3 Variables Categories Frequency Percent
(n) (%)
Age 15–19 82 20.1
20–24 304 74.5 Liquid waste storage Yes 42 99.5%
25–29 22 5.4 system No 2 0.5%
Educational status Cannot read and write 11 2.7 Type of liquid waste Latrine 27 61.4%
Primary 142 34.8
disposal system Septic tank 15 34.1%
Secondary and above 255 62.5
Open space 2 4.5%
Marital status Single 309 75.7
Functional kitchen Yes 43 97.7%
Married 99 24.3
No 1 2.3%
Length of ≤6 months 128 31.4
Availability of Clean Yes 31 70.4%
employment >6 months 280 68.6
Utensil No 13 29.5%
Have you received Yes 64 15.7
any training on food No 344 84.3 Availability of Shelf/ Yes 32 72.7%
safety cupboard No 12 27.3%

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Table 3 The Response of the Food Handlers About the Food Safety Knowledge Statements
No. Food Safety Knowledge Statement Yes (%) No (%)

1 Contaminated food always have some change in color, odor or taste 214 (52.5) 194 (47.5)
2 Healthy people can cause illness by carrying germs to food 314 (77.0) 94 (23.0)
3 Cooked foods do not have microbes 186 (45.6) 222 (54.4)
4 Contact between raw and cooked foods contributes to food contamination 341 (83.6) 67 (16.4)
5 Hand hygiene can prevent food contamination 297 (72.8) 111 (27.2)
6 Food handler with a disease such as diarrhea, flu and sore throat poses a risk of food contamination 187 (45.4) 221 (54.3)
7 Proper cleaning and sanitation of the utensils are very important in the food safety 354 (86.8) 54 (13.2)
8 Use of jewels such as rings, watches, wearing in food handling cause food contamination 157 (38.5) 251 (61.5)
9 Foods that are unfit for the consumption always does not have a bad smell and taste of spoil 238 (58.3) 170 (41.7)

Food safety knowledge

Good knowledge 139 (34.1)
Poor knowledge 269 (65.1)

Food safety attitude

Favorable attitude 304 (74.6)
Unfavorable attitude 104 (25.4)

Food handling practice

Good handling practice 219 (53.7)
Poor handling practice 189 (46.3)

on food safety, and attitude were significantly associated Trained food handlers were two times more likely to
with food safety knowledge. have good food safety practices than non-trained food hand­
Food handlers who did not attain any formal education lers (AOR=2.05, 95% CI=1.31–3.19). Knowledgeable food
were 77.0% less likely to have good food safety knowl­ handlers were 1.68 times more likely to practices good food
edge as compared to those food handlers who had com­ safety than non-knowledgeable (AOR: 1.68, 95% CI: 1.40,
pleted secondary educational level (AOR=0.23, 95% CI= 3.17). Similarly, the odds of having good food safety prac­
0.14–0.57). Similarly, food handlers who had completed tices among food handlers who had work experience greater
primary education were 73.0% less likely to have good than the attitude towards food safety were 24.0% higher
knowledge of food safety than secondary school and above when compared to their counterparts (AOR = 1.24, 95% CI:
(AOR: 0.27, 95% CI =0.09–0.45). Trained food handlers 1.10–2.81) (Table 5).
were 5 times more likely to have good knowledge of food
safety than non-trained food handlers (AOR: 5.13, 95% Discussion
CI=3.57–7.82). The odds of having good knowledge of Lack of knowledge on food safety and poor food handling
food safety among food handlers who had a favorable practice are the major contributors for food-borne disease
attitude towards food safety was nearly three folds higher and diarrheal related morbidity in Ethiopia. To overcome
as compared to those food handlers who had an unfavor­ these public health problems, the governments of Ethiopia
able attitude (AOR = 2.54; 95% CI: 1.52–4.25) (Table 4). should give emphasis on the knowledge of food handlers
on food safety and food handling practice. Therefore, this
Factors Associated with Food Handling study gives information on the level of knowledge and
Practices food handling practice in northwest Ethiopia.
During bivariable logistic regression analysis, educational In the current study, only 34.1% of food handlers had good
status, work experience, food safety training, and marital knowledge of food safety. This is consistent with studies done
status were significantly associated with food handling in northern Ethiopia,31 eastern Ethiopia,29 and India.32 In this
practice. While running the final multivariable analysis study, nearly one-fourth (23.7%) of food handlers did not
model, only food safety training, knowledge of food know that healthy people can cause illness by carrying
safety, and work experience remains significant. germs to food. Similarly, 61.5% of the food handlers did not

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Table 4 A Bivariable and Multivariable Logistic Regression Analysis Output of Associated Factors with Knowledge on Food Safety in
Debre Markos Town, Northwest Ethiopia, 2019 (n = 408)
Variables Knowledge COR (95% CI) AOR (95% CI)

Good Poor

Gender
Male 49 128 1.6 (1.39–2.54) 0.8 (0.55–1.45)
Female 90 141 1 1

Level of education
Not attained formal education 13 8 0.20 (0.12–0.43) 0.23 (0.14–0.57)*
Primary 69 61 0.14 (0.08–0.43) 0.27 (0.09–0.45)**
Secondary and above 57 200 1 1

Training on food safety

Yes 117 259 4.8 (2.23–10.61) 5.13 (3.57–7.82)*
No 22 10 1 1

Attitude
Favorable 51 40 3.3 (2.05–5.37) 2.54 (1.52–4.25)**
Un Favorable 88 229 1 1
Notes: *Significant at p<0.05; **significant at p-value<0.001.
Abbreviations: AOR, adjusted odds ratio; COR, crude odds ratio.

know that the use of jewels such as rings, watches, wearing in supported with a study done in the central part of Ethiopia that
food handling can cause food contamination and 54.3% did reported more than half of food handlers were not heard about
not know that food handlers with a disease such as diarrhea, the food-borne disease, causes, and mode of transmission of
flu, and sore throat poses a risk of food contamination. This is food-borne disease and reason for food contamination.27

Table 5 A Bivariable and Multivariable Logistic Regression Analysis Output of Associated Factors with Food Handling Practice in
Debre Markos Town, Northwest Ethiopia, 2019 (n = 408)
Variables Handling Practice COR (95% CI) AOR (95% CI)

Poor Good

Level of education
Not attained formal education 7 4 0.31 (0.20–0.54) 0.64 (0.41–1.57)
Primary 93 49 0.28 (0.13–0.38) 0.47 (0.34–1.27)
Secondary and above 89 166 1 1

Marital status
Not married 132 177 1 1
Married 57 42 1.8 (1.15–2.87) 1.37 (0.87–2.88)

Work experience
≤6 months 42 81 1 1
>6 months 147 138 2.07 (1.32–3.18) 1.24 (1.10–2.81)**

Training on food safety

Yes 48 16 5.13 (2.03–7.51) 2.05 (1.31–3.19)**
No 127 217 1 1

Knowledge on food safety

Good 102 37 6.29 (3.12–10.24) 1.68 (1.40–3.17)*
Poor 82 187 1 1
Notes: *Significant at p<0.05; **significant at p-value<0.001.
Abbreviations: AOR, adjusted odds ratio; COR, crude odds ratio.

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This study also revealed that only 53.7% of food handlers This study has several limitations. First, due to the
had safe food handling practices. The finding is nearly similar cross-sectional nature of the study, it is impossible to
to studies done in northern Ethiopia (31) and Malaysia.33,34 declare a causal relationship between independent vari­
However, this study is higher than a study conducted in Nigeria ables and the outcome of interest. Second, the study
(36.5%),35 Gondar, Ethiopia (30.3%),36 Arba-Minch might be liable to social desirability. Finally, parasitic
(32.6%),21 and Somali (20.9%).29 But, the finding is lower and microbiological laboratory analyses were not consid­
than other studies conducted in Jordan and Malaysia.24,37 The ered in this study.
discrepancy might be due to variation in institutions where
study participants were selected. For example, the study done
Conclusion
in Jordan was conducted in a hospital setting which might have
The current study reveals that the level of good food safety
better resources and a suitable setup for food handling practice
knowledge and good handling practice was relatively low.
which might improve food handlers’ practice.
Therefore it still needs further intervention and investigation.
The odds of having good knowledge of food safety were
Food handlers’ level of education, training on food safety, and
lower among food handlers who did not attain any formal
attitude were identified as the factors associated with food
education and who have primary educational status as com­
safety knowledge. Similarly, food safety training, knowledge
pared to those who have completed secondary education. The
of food safety, and work experience were identified as the
potential justification for this might be due to the fact that
factors associated with food handling practice. To improve
education might help food handlers to get better information
food handling practice, concerned bodies need to enhance
regarding food safety as compared to non-educated. Besides,
food handlers’ knowledge of food safety. Food safety-related
educated food handlers’ will also be able to read additional
training should be given continuously. The government of
written messages on food safety from a different source of
Ethiopia should give special attention to food handlers in
information such as leaflets, posters, or fliers and which in turn
food establishments in order to bring a better outcome in the
could positively affect food handlers knowledge on food
future.
safety.38
The odds of having good knowledge of food safety
were 5 times higher among food handlers who received Abbreviation
food safety-related training as compared to their counter­ AOR, adjusted odds ratio; COR, crude odds ratio; CI,
parts. This finding is supported by a previous study.38 This confidence interval; SPSS, Statistical Package for Social
is due to the fact that training could help them to acquire Sciences.
a better knowledge of food safety. Similarly, in the current
study, a good attitude towards food safety is positively
Data Sharing Statement
associated with food safety knowledge.
The data can be available from the corresponding author.
There is a significant positive association between
work experience and food handling practice. The odds of
performing good handling practice increased with pro­ Ethical Approval and Consent to
longed work experience. This is possibly due to experi­ Participate
ence might help food handlers to gain good knowledge The study was conducted following the Declaration of
and abilities regarding food handling practice. Likewise, Helsinki. Initially, ethical clearance was obtained from Debre
the odds of practicing good handling practices were higher Markos University ethical review committee (Reference num­
among trained food handlers as compared to their counter­ ber: DMU/RCS/078/2019). Then the detailed purpose of the
parts. This is due to the fact that training could help them study was explained to all study participants and written
to acquire a better knowledge of food safety. informed consent was taken from every participant. For study
Knowledge is the key element to influence food handling participants under the age of 18, the legal guardian of the
practices among the food handlers. Similar to previous studies participants provides informed consent on behalf of the parti­
in different parts of Africa,39–41 this study revealed that the cipants. All information collected from the respondents was
odds of having good handling practice was nearly two times treated as confidential in that no name was recorded on the
higher among food handlers who had good food safety knowl­ questionnaire and the collected data were kept using
edge than those who have poor knowledge. a computer password.

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Author Contributions 16. Dagne H, Raju RP, Andualem Z, Hagos T, Addis K. Food safety
practice and its associated factors among Mothers in Debarq Town,
All authors made substantial contributions to conception Northwest Ethiopia: community-Based Cross-Sectional Study.
and design, acquisition of data, or analysis and interpreta­ Biomed Res Int. 2019;2019:1549131. doi:10.1155/2019/1549131
17. Azanaw J, Gebrehiwot M, Dagne H. Factors associated with food
tion of data; took part in drafting the article or revising it
safety practices among food handlers: facility-based cross-sectional
critically for important intellectual content; agreed to sub­ study. BMC Res Notes. 2019;12(1):683. doi:10.1186/s13104-019-
mit to the current journal; gave final approval of the 4702-5
18. Chekol FA, Melak MF, Belew AK, Zeleke EG. Food handling prac­
version to be published; and agree to be accountable for tice and associated factors among food handlers in public food
all aspects of the work. establishments, Northwest Ethiopia. BMC Res Notes. 2019;12(1):20.
doi:10.1186/s13104-019-4047-0
19. Yenealem DG, Yallew WW, Abdulmajid S. Food safety practice and
Disclosure associated factors among Meat Handlers in Gondar Town: a
Cross-Sectional Study. J Environ Public Health.
The authors declare that they have no competing interests. 2020;2020:7421745. doi:10.1155/2020/7421745
20. Baraki N. Egata G. Food Safety Practice and AssociatedFactors
among Food Handlers in Public Food Establishments of Godey
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