Food hygiene practice and associated factors among food handlers working in food establishments in sub-Saharan Africa: a systematic review and meta-analysis.

Introduction: Food hygiene practices are crucial to avoid foodborne illness and improve human well-being. Millions of people get sick, and many of them pass away due to eating unhealthy food. Foodborne diseases are still a public health problem in developing countries.

Objective: This study aimed to determine the prevalence and factors associated with food hygiene practices among food handlers in sub-Saharan Africa.

Methods: An extensive search was conducted using various databases including PubMed, Science Direct, African Journal Online, and Google Scholar. The search results were then extracted using Microsoft Excel. The data analysis was conducted using STATA version 14. Publication bias was checked by funnel plot, and more objectively through Begg and Egger regression test, with P < 0.05 considered to indicate potential publication bias. A random effect model was used to calculate the pooled prevalence of hygienic food handling practices. Sub-group analysis was done by country and study site.

Results: To estimate the pooled prevalence of food hygiene practices in sub-Saharan Africa, 42 reviewed studies and 12,367 study participants were included. The pooled prevalence of food hygiene practices among food handlers in sub-Saharan Africa was found to be 50.68% (95% CI: 45.35, 56.02) in this study. Factors associated with food hygiene practices included lack of food safety training (OR = 2.14 95% CI: 0.68, 6.76), negative attitude (OR: 2.36, 95% CI: 1.36, 4.09), and lack of regular medical checkups (OR: 2.66, 95% CI: 1.52, 4.65) among food handlers.

Conclusion: This research found that only half of sub-Saharan Africa's food handlers had good food hygiene practices. Lack of food safety training, a lack of regular medical checkups, and unfavorable attitudes toward food hygiene practices were factors contributing to food hygiene practices. Thus, the authors recommended that food workers receive food safety training about food hygiene and safety procedures.