Chapter One To Three
Chapter One To Three
Chapter One To Three
NIGERIA
BY
JANUARY, 2013
CERTIFICATION
We certify that this research was carried out by Muhammed Isiaku IMAM of the Department of
Environmental Health Sciences, Faculty of Public Health, College of Medicine, University of
Ibadan, Ibadan.
………………………………………………………………………………………………………
Supervisor
B.Sc (PH), M.Eng (PH), MPH (Ib), PhD (Ib), FLEAD (UK), MRSPH(UK), MAPHA (USA).
………………………………………………………………………………………………………
Co- Supervisor
ii
DEDICATION
This work is dedicated to GOD Almighty with whom all things are possible
and
To Dr. Gbaruko B.C, a course mate who died in a ghastly motor accident during the course of
the programme. May his soul rest in perfect peace.
iii
ACKNOWLEDGEMENTS
I am grateful to God for his guidance and mercy towards me from the beginning of this
programme to the end. I am also full of praise to God for making it possible to put this work
together. I am particularly grateful to my wife Dr. Mrs. Zainab Imam for the utmost support
given to me throughout the programme. My appreciation goes to my daughters, Fareedah and
Safeyyah who have had to do without me many times in the course of this work, and my Parents
Alhaji Muktar Imam and Mrs. Husennah Imam for their support and prayers throughout this
programme.
Sincere gratitude and appreciation goes to my supervisor, Dr. G.R.E.E Ana, and Co-supervisor
Dr. O.E Oyewole for their intellectual inputs and support in the course of bringing this project to
a successful completion. Dr. Ana, your encouragement, motivation, and kind words were the
major factors that contributed to the completion of this work. There were times of fatigue,
disappointments and frustration in the course of this project, your words and reassurance helped
a lot and it is my sincere prayer that you and your entire household will always find favors in all
your endeavors, and from the bottom of my heart, I say a big THANK YOU SIR. Dr. Oyewole,
your involvement in this work once again proved to me that every man is blessed with a special
talent and I thank you for assisting when it matters most. May God bless you and your family in
abundance.
My special gratitude goes to Dr. E. Oloruntoba for your invaluable assistance towards my
securing admission into this noble course of Public Health, your efforts as a teacher will never be
forgotten. My gratitude also goes to my lecturers who assisted me in one way or the other during
the course of this project most especially in the correction of abstract. Therefore, Dr. B.O
Adedokun, Dr. O.T Okareh, Dr. O.B Yusuf and Dr. I. Ajayi, all your efforts are greatly
appreciated. I thank Dr. E. O Adeleke and Mr. Odewale of Department of pharmaceutical
Microbiology of University of Ibadan for their immense contributions to the laboratory
component of this work.
I acknowledge the prayers love and support my sister and her husband Mr. and Mrs. Adisa, May
the almighty God continue to protect you and your family. The assistance and moral support
iv
given by Dr. A. Adebayo and Dr. B. Adebayo of the Departments of Community Health and
Pediatrics respectively cannot be forgotten.
The immense efforts of my fellow colleagues towards the completion of this project are highly
appreciated. Thank you Messer Thony, Badmus, Laurence, Tayo and Pastor Adeniji. I also wish
Miss Bimbo, Gloria, Cindy, Amina and Joy the best of luck for assisting me through the course
of the project. And to my other colleagues and course mates not mentioned, you are all a jolly
good fellow.
Lastly, this work wouldn‟t have taken place without the support and cooperation of the kitchen
staff, teaching and non-teaching staff of the schools that the study was carried out. I will like to
acknowledge the help and support of all these people especially the principals of each individual
school.
Imam
v
ABSTRACT
Cases of food contamination and poisoning in boarding schools have been reported in Nigeria.
Although researches have been carried out on food safety in Nigerian schools, not many studies
were conducted in boarding schools despite the health implications of consuming unsafe food.
This study was designed to assess the food safety and hygiene conditions in selected Public
Secondary Schools with Boarding Facilities(PSSBF) in Ibadan, Nigeria.
Stratified random sampling technique was used to select five out of ten PSSBF in Ibadan. A
semi-structured interviewer administered questionnaire was used to elicit information on
Knowledge, Attitude and Practice (KAP) of food safety and hygiene among 59 food handlers. A
40, 24 and 30 point scales was used to assess the food handlers KAP respectively. Food hazards
and sanitary conditions were assessed by direct observation using a 30-item checklist. Forty-two
food samples were collected immediately after cooking from kitchens and dining halls of
schools. Food holding temperature was measured by inserting thermocouple in the mid region of
the food samples. Borehole, well and Tap water samples used for dish-washing, cooking and
drinking were collected from the schools. Food and water samples were assessed for bacteria
using pour plate and multiple tube method and results expressed in cfu/g and cfu/ml respectively.
Values obtained from analysis of food and water samples were compared with United States
Food and Drug Administration (USFDA) and Standard Organization of Nigeria (SON)
respectively. Descriptive statistics, Chi-square test, t-test and ANOVA were used for data
analysis at p=0.05
Mean age of food handlers was 34.5±10.1 years. Mean Knowledge Attitude and Practice scores
on food safety was 26.9±4.9, 13.4±3.2 and 21.9±3.8 respectively. Objects observed in food
sampled were artificial finger nails, drug capsules, and tiny metals. Toilet facilities in the schools
were in poor sanitary conditions with no running water. The mean temperature at holding for
food samples in oC were: rice (57.4±4.6), “moi-moi” (57.1±5.9), “akamu” (34.3±1.5), vegetable-
soup (59.0±6.7) and yam-porridge (63.4±3.6). There was a significant difference between
temperature at holding for all food compared to the USFDA standard. The types and loads of
bacteria isolated from the food samples were Escherichia coli (4.4x108), fecal coliform
(5.1×108), Staphylococcus aureus (1.2x108) and Bacillus cereus (8.4x108) cfu/g. These were
significantly higher than USFDA standard for food safety. Mean total coliform of 18 and
vi
16cfu/100ml were obtained for cooking and drinking water respectively. Total coliform for
cooking and drinking water exceeded SON water safety level.
The level of food and water contamination in the schools was high. Although the food handlers
have average knowledge of food safety and hygiene, the hygiene condition of food surroundings
and toilets was poor. Therefore, there is need for hygiene education, training on food safety and
regular monitoring in boarding secondary schools.
Keywords: Boarding schools, Food handlers, Food hazards, Hygiene practices, Food safety.
vii
TABLE OF CONTENT
Pages
Title ………………………………………………………………………………………….i
Certification……………………………………………………………………………….....ii
Dedication………………………………………………………………………….………..iii
Acknowledgements……………………………………………………………………. …...iv
Abstract……………………………………………………………………………………...vi
Table of content…………………………………………………………………………..viii-xii
List of Tables………………………………………………………………………….........xiii
List of Figures……………………………………………………………………………....xv
List of Plates……………………………………………………………………………….xvi
Acronyms…………………………………………………………………………………..xvii
CHAPTER ONE
INTRODUCTION
CHAPTER TWO
LITERATURE REVIEW
2.1 Food 8
2.2 Food Safety 9
2.3 Food-Handling Practices in Schools 10
2.4 Food safety in school 12
viii
2.5 Food Poisoning 13
2.6 Knowledge Attitude and Practice on Food Safety 14
2.7 Environment Sanitation 16
2.8 Education 16
2.8.1 Formal Education 16
2.8.2 Non Formal Education (NFE) 17
2.8.3 Informal Education 17
2.9 Food Hygiene 18
2.9.1 Nigerian Policy on Food Hygiene and Safety 18
2.9.2 National Legislations on food Safety 18
2.9.3 The Federal Ministry of Health 19
2.9.4 National Agency for Food and Drug Administration and Control
(NAFDAC) 19
2.10 Boarding School 19
2.11 School Health 21
2.12 Health Promoting School 22
2.13 Food Related Health problems in School 23
2.14 Water and Sanitation 23
2.15 Water quality 24
2.16 Safety of Food and Water 25
2.17 Food handlers 26
2.18 Bacteria food contaminants 27
2.19 Sources of pathogenic Bacteria 28
2.20 Bacillus Cereus 28
2.21 Staphylococcus aureus 29
2.22 Escherichia coli 30
2.23 Coliform Bacteria 31
2.24 Food Safety Practices of Food Handlers 31
ix
CHAPTER THREE
METHODOLOGY
3.1 Study Design 33
3.2 Description of Study Area 33
3.3 Sampling Methods 34
3.4 Data Collection Procedure 34
3.4.1 Study Population 34
3.4.2 Sample Size 34
3.4.3 Inclusion Criteria 35
3.4.4 Exclusion Criteria 35
3.5 Materials and Methods 35
3.5.1 Food sample collection 35
3.5.2 Water sample collection 36
3.5.3 Microbiological analysis of food samples 36
3.5.4 Microbiological analysis of water samples 36
3.5.5 Water Analysis Using Pour Plate Method 36
3.5.6 Detection and Enumeration of Coliform Organisms 37
3.5.7 Multiple tube method 37
3.5.8 Procedure for presumptive test 37
3.5.9 Procedure for Confirmed test 39
3.5.10 Quality assurance and Quality control Procedures 39
3.6 Survey Methods 39
3.6.1 Questionnaire 39
3.6.2 Onsite Observation 40
3.63 In-Depth Interview 41
3.6.4 Statistical analysis and Data management` 43
CHAPTER FOUR
4.0 RESULTS
4.1 Socio-Demographic characteristics of Food Handlers 44
4.2 Food safety education and training 46
x
4.3 Medical Examination of food handlers 48
4.4 Environmental features 48
4.4.1 Water Supply 48
4.4.2 Sewage and Refuse disposal in schools 51
4.4.3 Access to water source, sewage and refuse disposal facilities 53
4.5 Domestic animals in cooking area 55
4.6 Pest control 55
4.7 Food Storage 55
4.8 Cooking Methods 55
4.9 Food holding temperature 60
4.10 Food holding time 64
4.11 Microbial Quality of food and water 66
4.12 Microbial Quality of cooked food 66
4.13 Microbial quality of water 68
4.14 Knowledge Attitude and Practice on food safety 70
4.15 Knowledge of food safety in relation to Sex, Marital Status, Level
of Education and Age of Food Handlers 74
4.16 Food safety Attitude in Relation to Sex, Marital Status, Level of
Education and Age of food Handlers 76
4.17 Food safety Practice in Relation to Sex, Marital Status, Level of
Education and Age of Food Handlers 78
4.18 On-site Observation on Hygiene and Sanitary Conditions of Schools 80
4.19 Sanitary/Hygiene Conditions of the Kitchens in School 80
4.20 Sanitary/Hygiene Conditions of the Toilets in Schools 99
4.21 Sanitary/Hygiene Conditions of the Dining in Schools 101
4.22 Personal Hygiene of Food Handlers in Schools 103
4.23 Relationship between holding temperature and microbial load in food 105
4.24 Findings from In-depth Interviews with School Nurses and
Head of Food Departments 107
xi
CHAPTER FIVE
DISCUSSION
5.1 Socio-demographic characteristics of food handlers 109
5.2 Microbiological Quality of Food Samples 110
5.3 Microbial quality of water used in food preparation 112
5.4 Mean temperature of food 113
5.5 Methods of Cooking 113
5.6 Food handling practices 114
5.7 Knowledge Attitude and Practice of Food Handlers on food safety 115
5.8 Sanitary conditions of kitchen, Dining and Toilet 116
5.8.1 Kitchen Area 116
5.8.2 Toilet Facility 117
5.8.3 Dinning Facility 117
5.9 Personal Hygiene of Food Handlers 117
CHAPTER SIX
CONCLUSIONS AND RECOMMENDATIONS 118
6.1 Conclusions 118
6.2 Recommendations 119
REFERENCES 121
APPENDICES 132
xii
LIST OF TABLES
Table Pages
xiii
Table 4.21: Sanitary/Hygiene Conditions of Dining in Schools 102
Table 4.22: Personal Hygiene of Food Handlers in Schools 104
Table 4.23 Food holding temperature and microbial loads in food 106
xiv
LIST OF FIGURES
Pages
Figure 4.1: Methods of pest control in schools 57
Figure 4.2: Methods of cooking in schools 59
xv
LIST OF PLATES
Pages
xvi
ACRONYMS
NAFDAC National Agency for Food and Drug Administration and Control
xvii
CHAPTER ONE
INTRODUCTION
Unsafe food has been a human health problem for long, and cases of food borne illness occur
daily. Although, governments all over the world are doing their best to improve the safety of the
food supply, the occurrence of food borne disease remains a significant health issue in both
developed and developing countries. As most of these cases are not reported, the true dimension
of the problem is unknown (WHO, 2002). Millions of people become ill and many die due to
consumption of unsafe food and water. Up to one third of the population of developed countries
are affected by food borne illness each year (FAO &WHO, 2002). In recent times, concerns
about safety of food have replaced those of the quantity of food. Many feel that such concerns
are products of our convenience but the basic truth is that the majority of disease and
contaminations of man and animals are from food we consume. .It has been estimated that each
year 1.8 million people die as a result of diarrheal diseases and most of these cases can be
attributed to contaminated food or water. Each weekday, millions of American students eat
meals prepared and served at school (Burghardt et al, 1995).
Food safety and hygiene condition is essentially important most especially in the situation where
food is cooked in large quantities that involve large numbers of food handlers. A good example
is boarding school. The consolidation of small food processing operation to larger one e.g.
restaurants, boarding schools, hotels etc, may contribute to an increase in food borne disease.
Food safety is an important part of providing school children with acceptable, safe, and nutritious
meals. There is evidence that improvements is needed in the area of food safety in schools, thus
the goal of the school food service program is to serve meals that are acceptable, safe, and
nutritious (Neill, 1980).
There are incidences of food borne diseases in Nigerian schools. However, the epidemiological
data of these outbreaks is either often unavailable or the incidence of contamination is grossly
underreported. In 1994, a class of medical students of the University of Lagos, Nigeria came
down with a strange illness after consuming a dinner of freshly made salad which was
1
inadvertently contaminated with salmonella (Tribune, 1994). Lack of knowledge of food safety,
poor personal hygiene, and poor storage practices common with food handles in the boarding
school is of great concern. Thus, unsafe environment poses many hazards to food preparation.
The hygienic quality of prepared food can be assured if basic food safety principles are observed
(Ehiri et al, 2001)
Poor housekeeping, poor personal hygiene and more specifically hand hygiene can compromise
food safety and it is significant risk factors in the transmission of food-borne pathogens (Kilgore
et al 1996). The slightest food handling mistake by just one person or just one stage of food
preparation may affect large number of people and may result in massive food disease outbreak.
Hence, hygienic quality of prepared food can be assured if basic food safety principles are
observed (Ehiri et al, 2001).
Microorganisms are essential components of our environment and they are ubiquitous in the
environment. They are in the air, food, water and soil, on the surface of objects such as cooking
utensils, as well as in/on our bodies (skin, head, mouth, hand etc). Microorganisms live in, on
and with man and animals. Ordinarily, microorganisms are of no threat to healthy humans while
some are quite beneficial.
There is an estimated 2 million death in children worldwide due to the consumption of unsafe
food (Koepke et al, 2008, Miller et al, 2008). Chemicals, heavy metals, parasites, fungi, viruses
and bacteria can make food unsafe and cause food borne illness. However, bacteria related food
poisoning is the most common, but less than 20 of the many thousands of different bacteria
actually are the culprits. More than 90 percent of the cases of food poisoning each year are
caused by Staphylococcus aureus, Salmonella, Clostridium perfringens, Campylobacter, Listeria
monocytogenes, Vibrio parahaemolyticus, Bacillus cereus, Entero-pathogenic Escherichia coli,
proteus (WHO, 2004). These bacteria are commonly found on raw foods like salads, eggs, beef,
vegetables, cheese, ice cream, unpasteurized milk, fish, fresh fruits, canned foods, mushrooms
etc( Noah, 2009, Fry et al, 2005).
2
Food contamination can occur in any stage of food preparation, transportation, distribution and
storage. It is however essential to protect the school food from microbial, physical, chemical and
all other forms of contamination. The involvement of E coli in several cases of food poisoning
suggested that this organism rather than fecal coliform group should be used as an indicator of
sanitary quality. Microbiological standards in most developed countries rely on total coliform
and E.coli as markers for enteric organisms.(Karatz et al, 1999). Many developing countries
suffer from either chronic shortages of fresh water or pollution of readily accessible water
sources (Lehloesa and Muyima, 2000). According to United Nation Children‟s Fund (UNICEF)
report, about 800 million people in Africa and Asia are living without access to safe drinking
water. This has exposed many people to various diseases. (Tanwir et al, 2003).
The World Health Organization defines a health-promoting school as one that constantly
strengthens its capacity as health setting for living, learning and working (WHO, 1999). Thus the
goal of school food safety monitoring is to keep food wholesome. It is important that boarding
school children have portable water to drink, adequate water for hygiene, adequate sanitation
facilities, safe food and safe clean environment.
Environmental challenges and opportunities vary considerably among schools across countries
and within communities around the world. Food environment refers to all entity micro or macro
that comes in contact with food. These items can directly or indirectly influence wholesomeness
of the food .These environmental factors therefore must be in a clean condition or in acceptable
limits at all times. The food environment include bacteria, cooking utensils, food handlers, food
storage facilities, food temperature, food plates, spoons, toilet, kitchen , water used for cooking.
The food temperature plays very significant role in determining the wholesomeness of the food
consumed in the boarding schools and good temperature control is essential to keep foods safe.
Products such as prepared ready-to-eat foods, cooked food, smoked meat or fish, and certain
dairy products must, by law, be kept hot or chilled until they are served to the students in the
boarding schools. If not, harmful bacteria could grow or toxins (poisons) could form in the food
and make the student and staff ill. Foods that are taken chilled should be held at 8°C (46°F) or
below while those eaten hot should be held above 63°C (145°F). Research have shown that the
factors most commonly associated with food borne illness outbreaks include food purchases
3
from unsafe sources; inadequate cooking or reheating; holding at room temperature in advance
service; cross-contamination from other foods or food contact surfaces; poor personal hygiene;
or improper food handling practices (Richards et al, 1993; Martin et al, 1986)
Many researches on food safety in schools have been carried out in Nigeria but there are not
many food safety research carried out in structured school environment like the boarding
schools. This may be due to the little priority given by the health decision –makers to issues
relating to school health system and food safety.
A little over 600 food borne disease outbreaks in American schools were reported to the Centre
for Disease Control between 1973 and 1999 (McCabe-Sellers and Beattie, 2004; Flanigan,
2006). This figure is worrisome, more so that most food outbreaks in schools are grossly
underreported. This situation is of great concern in Nigeria schools considering the fact that few
cases of outbreaks of food borne illnesses are reported by the health authorities.
In April 2008, about two hundred students at Doma Government Secondary School for Girls
were hospitalized for several days and treated for diarrhea after consuming beans meal
(Vanguard, Nigeria, 2008). Also in 1993, an entire class of medical students of the University of
Lagos Nigeria contracted a strange illness after consuming a dinner of freshly made salad that
was inadvertently contaminated with salmonella (Nigerian Tribune, 1994).
4
Several cases of bacterial food poisoning were reported within the student community of
Ambrose Ali University, Ekpoma Nigeria. The researcher later isolated microorganisms causing
food poisoning like B cereus, proteus, and Staph aureus. The study also reported the major
unhygienic practices observed among the food handlers such as poor care of immediate cleaning
and failure to wear covering apron (Oni et al; 2010).
In 1998, research showed that infants, elderly and institutionalized adolescents such as students
in the boarding schools, some of whom are under emotional and psychological stress as a result
of academic rigor and absence from family members are at higher risk of food and water borne
diseases even at low doses of enterotoxigenic strains of microorganisms (Nataro et al; 1998).
Vendors who prepared food well in advance (over 4 hours) were found to practice food re-
heating more than those who prepared food within 4 hrs and there are serious health implications
when food are not stored or taken within certain safe temperatures. This study underscores the
fact that the school food vendors and handlers may not have been complying with food holding
time and temperature regulations (Musa and Akande, 2003).
In 2010, studies showed that less than 20% food handlers had a good level of knowledge, attitude
and practice on food sanitation while 80% of the food handlers need to improve knowledge,
attitude and practice towards choosing low quality raw materials, using cloths to clean utensils,
storing ready-to-eat foods in cabinets to protect them from pests or vectors control . It was found
that there was a significant relation between knowledge and practice of food handlers. This study
emphasize the significance of Knowledge, Attitude and Practice of food handlers towards ensuring food
safety in boarding schools ( Thidarat et al; 2011).
In Zaria, studies were carried out on food safety in boarding secondary schools using HACCP.
The study discovered that the lack of good personal hygiene of the food handlers may
compromise safety of foods served in boarding schools (Oranusi et al; 2007), while the
researcher in Abeokuta, Nigeria who worked on the microbiological quality and safety of ready
to eat food sold in secondary schools reported a high level of microbial contamination of the
food and attributed this to poor hygiene practices among the food handlers in the secondary
schools (Mejayi, 2011).
5
More recently, an outbreak of salmonella strain contamination of tomato, spinach and cabbage in
United State of America resulted in several illnesses and death. This was blamed on the handling
process in some of the many stages of preparation of the vegetable produce. This indeed is of
serious public health concern (CDC,2012).Food borne disease outbreak is a common
phenomenon, the fact that it is seldom reported does not make it less important, it only increases
the vulnerability of students and staff in boarding schools and the entire populace to the
untoward consequence of such outbreak. Therefore, the food safety and hygiene conditions of
food prepared in boarding school are often implicated when food disease outbreak occurs.
.
1.3 Rationale for the study
The increasing incidence of food borne disease in Nigerian secondary schools necessitates a
study like this. Although, previous studies attempted to assess food safety in schools, not many
studies were conducted in boarding secondary schools.
Chemicals, heavy metals, parasites, fungi, viruses and bacteria can make food and water unsafe
for consumption and may lead to food borne disease outbreak. Bacteria related food
contamination is the most common, hence this study would provide information on the common
bacteria that are found in school menu and also determine the microbiological quality and the
safety of food in the boarding schools .
Unsafe environment poses many hazards to food preparation; however the hygienic quality of
prepared food can be achieved if basic food safety principles are observed (Ehiri, 2001). Food
temperature, dining hall environment and food preparation area are some of the important food
environments that could make food consumed unsafe, thus the study will provide information on
the temperature at which food is being held for consumption, KAP of food handlers on food
safety and sanitary condition of toilets, dinning and kitchen in the food preparation areas.
More research on food handling practices, sanitary and hygiene conditions of food handlers in
boarding schools will not only increase awareness on food safety but also enhance optimal
sanitary environment and overall food safety in the boarding schools.
6
1.4 BROAD OBJECTIVE OF THE STUDY
The broad objective of the study was to assess food safety and hygiene conditions in selected
Public Secondary Schools with Boarding Facilities in Ibadan.
7
CHAPTER TWO
LITERATURE REVIEW
This chapter is a review of available literature particularly in Nigeria, Africa and other parts of
the world. It involves all aspects of food safety and hygiene, microbiological contamination of
food, food handlers, Knowledge, Attitude and Practices of food handlers and food safety
assessment.
2.1 Food
Food is life. In Abraham Maslow‟s hierarchy of needs, the most important need after life is the
requirement for food. The American psychologist could not have been more accurate in his
conceptualization of a "hierarchy of human needs." Food is any substance consumed to provide
nutritional support to the body. It is usually of plant or animal origin, and contains essential
nutrients such as carbohydrates, proteins, fat, vitamins and mineral. Food is usually ingested by
an organism and assimilated by the organism's cells in order to produce energy, maintain life and
stimulate growth.
Food can also be described as every article manufactured, sold, or represented for use as food or
drink for human consumption, or any item that enters into or is used in the composition,
preparation, or preservation of any food or drink. Food and drink include confectionery and
chewing substances and their respective ingredients (Food Act, 1983)
Like many other developing countries, Nigeria faces the challenge of providing adequate food
supply for its teeming population. Towards this end, policies and programmes aimed at boosting
agricultural and food production are being actively promoted, but the issue of food safety still
poses a more daunting challenge. Therefore, Nigeria has to contend with the problem of food-
borne diseases with its attendant social, economic and health costs.
Food has been identified globally as not only a biological need but also as an economic and
political weapon. It is constantly a potential source of socio-political problems in communities
and nations. Therefore, it is pertinent to have an assurance that food consumed is adequate,
nutritious, good quality and wholesome.
8
2.2 Food Safety
Food safety is a scientific discipline describing handling, preparation, and storage of food in
ways that prevent food borne illness. This can also be described as a condition achieved by series
of actions including processing, handling storage and preparation aimed at ensuring that all food
are safe as possible, reducing health hazards and preventing food poisoning and food-borne
illness.
The goal of food safety monitoring is to keep food wholesome. This involves the protection of
food supply from microbial, chemical (i.e. rancidity, browning) and physical (i.e. drying out,
infestation) hazards or contamination that may occur during all stages of food production,
harvesting, processing, transporting, distributing, preparation and storing (WHO, 2002).
Food safety is an important part of providing acceptable, safe, and nutritious meals. The goal of
the school foodservice program is to serve meals that are acceptable, safe, and nutritious (Neill,
1980). Food safety certification of employees and implementation of a Hazard Analysis Critical
Control Point (HACCP) program are two ways to achieve these goals (Giampaoli, 2002). The
food safety certification process was initiated to establish minimum standards of food safety
practices and provides information necessary to train employees in food safety and implement a
food safety system. Strengthening food safety measures in schools would better protect students
and school staff from outbreaks of food borne illness (Almanza, 2003).
While food safety is considered to be an important issue in school food service, there have been
several recent outbreaks of food borne illness in schools and research shows that good sanitation
procedures and efficient food-handling practices are not always followed in school meal
programs (Sukyung and Sneed, 2003). Food safety has always been a concern in school food
service, and the recent emphasis on Hazard Analysis of Critical Control Point (HACCP)
programs has increased awareness of food-handling practices in schools. In developing a quality
model for school food service, food quality was included as an integral part of food safety and
was described as food that is selected, prepared, and served in a way that retains the natural
flavor , identity, nutritious state of the food and free of unsafe bacteriological or chemical
contamination (Gilmore and Dana ,1998).
9
There is rising concern for food safety as it relates to all phases of food production and
preparation from “farm to fork." The growing importance of food safety in schools is evident
with the recent adoption of the following food safety position statement by the American School
Food Service Association (ASFSA, 1999). The ASFSA initiates and support collaborative efforts
to ensure that schools develop food safety systems so that students have safe food in schools."
More recent school estimates suggest that there were 292 outbreaks between the years of 1990
and 1999, causing 16,232 students to become ill as a result of food borne illness and that the
number of reported outbreaks actually has increased on an average by 10% per year . It should be
noted that there was a change in surveillance methodology beginning in 1998 that might account
for higher numbers of incidents. Most commonly identified microorganisms for illness outbreaks
connected to school foods were salmonella and Norwalk-like viruses and as a result, it has been
suggested that USFDA take actions to better ensure the safety of school foods (GAO, 2002). The
safety and integrity of food prepared for consumption in boarding schools can be maintained if
food handlers effectively wash hand before touching any food related objects, food surfaces and
equipments are well cleaned, food are thoroughly cooked, food handlers maintain good and
standard personal hygiene, adequate cooking and reheating are maintained, effective temperature
control of hot and cold food are ensured, food are adequately stored and food handlers endeavor
to report illness as soon as they fall ill. In order to ensure food prepared in the schools are safe at
all times, every person that is involved one way or the other with food preparation must abide
with the following rules to safe food. These involves keeping a clean environment, separating
raw and cooked food, thorough cooking, keeping food at safe temperatures and the use of safe
water and raw materials at all time (WHO, 2006).
10
(Blakeslee & Penner, 1999; FDA, 2004; Giampaoli, Cluskey, & Sneed, 2002; Gilmore & Dana,
1998).
Food quality model for school foodservice operations was developed and tested. In this process,
these researchers conducted observations in eight school kitchens in Iowa and Minnesota,
reviewing food receiving practices, food production sanitation steps, and food-handling
techniques. Many sanitation practices were good, including clean uniforms, short and unpolished
fingernails, appropriate use of utensils/gloves for handling food, sanitizing of work surfaces, and
the thawing of foods. Researchers did observe that hand washing was infrequent, hair restraints
were not used, and jewelry was not limited to watch and wedding band. They also observed that
food handlers made use of reusable towels to dry dishes/utensils in some kitchens. These
findings are consistent with observations of food-handling practices in subsequent research
studies Gilmore and Dana (1998).
A study was conducted to develop baseline data on the risk factors for Foodborne illness in retail
foodservice operations, including schools, hospitals, nursing homes, restaurants, and retail food
stores. Overall, elementary schools were in 80% compliance for the items observed. Improper
holding and time/temperature relationships were the area with the lowest compliance (60.5%)
and personal hygiene was next at 74.2% compliance. For cold foods, 45% of schools did not
hold them at a cold enough temperature. Improper or inadequate hand washing was seen at 36%
of those schools that were out of compliance for personal hygiene, while 27% of the schools did
not take steps to prevent hand contamination (FDA, 2000).
Employees in 15 school districts in the Silicon Valley, California was observed by researchers, it
was found that proper hand washing techniques were often not used, that the majority of
employees did not wear hair restraints, and that employees were observed eating and drinking in
the kitchens. Some food storage practices were inappropriate, such as boxes being stored on the
floor, raw meats stored above other food items, and inadequate labeling and dating of food in
storage. Sanitizing issues, such as not checking temperature/sanitizer concentrations and not
using sanitizing agents on food contact surfaces, also were identified (Giampaoli, Cluskey, and
Sneed, 2002).
11
In a study of 40 Iowa school districts, several food-handling issues were identified. About one-
third of the observed employees either did not wash their hands frequently enough nor use
appropriate hand washing techniques. Food temperature was not taken and in instances when
these were taken, the temperatures were not recorded. Calibrated thermometers often were not
used (and employees often were not aware of calibration procedures). Researchers checked
temperatures of both hot and cold food items at the time of service and found more problems
with appropriate cold food temperatures than hot food temperatures, which is consistent with the
FDA study (2000).
In a study of five boarding secondary schools in Zaria Nigeria, researchers revealed some factors
that could contribute to contamination of foods prepared in boarding schools. The factors such as
improperly washed utensils and equipments, poor hygiene, dirty environment and the presence of
animals in the cooking environment. The major hazards associated with foods prepared in the
studied schools were inadequate (5 - 10 min) time/temperature exposure of foods (akamu, tuwo,
eba), extensive handling of foods by cooks after preparation, leaving cooked foods open till
served to students and the presence of toxigenic strains of B. cereus and E. coli. The cooking
temperatures of foods examined in this study reached levels capable of destroying many
vegetative forms of food borne pathogens. However, a concentration of organisms ranging from
2-5log10 cfu/g survived in the foods after cooking (Oranusi et al, 2007).
Several outbreaks in schools have been attributed to contamination of food by food-handlers who
worked while ill (Quiroz et al 2000), or had poor personal hygiene (Daniels, 2000., Holmberg
et al, 1984). In a review of reported food borne outbreaks in school, 57% of outbreaks were
12
attributed to likely contamination by food-handlers. The adoption of a work policy that includes
paid leave for food handlers with gastroenteritis would probably increase compliance with illness
related work exclusion policies. Training and certifying all food handlers in school cafeterias in
specific techniques, such as good personal hygiene, adequate hand washing, proper cooling and
reheating of foods and methods of preventing cross-contamination between cooked and raw
foods, would also likely reduce the incidence of food borne disease outbreaks (Manning , 1994).
Furthermore, food handlers could be important reservoirs for pathogenic bacteria in boarding
schools, increased time/temperature exposure of foods and strict control of mishandling of food
during preparation and dispensing is highly recommended for prevention of contamination.
A failure of hygiene standard in any stage of food preparation could cause food poisoning.
Harmful bacteria that cause food poisoning can spread very easily, so it is important to ensure
that contamination is prevented. Food poisoning can lead to serious illness, or even death,
13
especially among the very young, the very old and ill people, who are particularly at risk from
food poisoning
There are four main defenses against the growth and spread of bacteria:
1. Ensuring food areas are clean and good standards of personal hygiene are maintained
2. Cooking foods thoroughly
3. Keeping foods at the right temperature
4. Preventing cross-contamination
Knowledge is the capacity to acquire, retain and use information; a mixture of comprehension,
experience, discernment and skill. The possession of knowledge requires complementarities
between two basic ingredients: the concept through which an object is thought of at all, this
requiring intellect; and the perception by which the concept is acquired, this requiring power of
sense. The nature of knowledge rests on the different modes of acquisition of ideas: perception,
imagination, memory, judgment, abstraction and reasoning. Knowledge criteria center on the
sense that allows us to distinguish between right and wrong. Thus education is the prerequisite of
knowledge. There was general agreement revealed from several authors as good levels of
knowledge towards food safety among food handlers and the effective practices of such
knowledge in food handling were imperative in ensuring the safe production of food in any
catering operations ( Mortlock et al,1999).
A recent study on the KAP on food safety in Indian schools showed that about 50- 70%, of the
respondents‟ food handlers in the school do not know that diarrhea, abdominal pain, nausea and
14
vomiting may be a symptom of food-borne disease‟ When asked on storage of food, 75%
reported to leave the cooked food at room temperature and only 29.4% of them consumed the
stored food after thorough heating ( Sudershan et al, 2009). Among the food handlers, 13.0%,
18.5% and 15.2% (n=92) had a good level of knowledge, attitude and practice respectively on
food safety. From statistical analysis, there was a significant relation between food safety
knowledge and food safety practice and between food safety attitude and food safety practice.
Attitude refers to inclinations to react in a certain way to certain situations; to see and interpret
events according to certain predispositions; or to organize opinions into coherent and interrelated
structures. Howes et al, (1996) indicate the correlation of positive behavior, attitudes and
continued education of food handlers towards the maintenance of safe food handling practices.
On the other hand, Bas et al. (2004) in their study found that the attitude scores of the food
handlers toward food borne diseases prevention and control was poor (44.2 ± 13.2) and practice
scores were very low (48.4 ± 8.8). According to Howes et al. (1996), a study in the USA showed
that approximately 97.0% of foods borne outbreaks were due to improper food handling
practices in food service. Previous reports indicate that beside poor hand and surface hygiene,
lack in personal hygiene among food handlers was also one of the most commonly reported
practices that gave rise to food borne illness (Collins, 1997). This shows that if food handlers
take serious note on the cleanliness of their hand, body and clothing, this will help in preventing
incidence of cross-contamination from occurring (Sneed et al. 2006)
Practice is the application of rules and knowledge that leads to action. Good practice is an art that
is linked to the progress of knowledge and technology and is executed in an ethical manner.
According to Howes et al. (1996), a study in the USA showed that approximately 97.0% of food
borne outbreaks was due to improper food handling practices. Previous reports indicate that
besides poor hand and surface hygiene, lack of personal hygiene amongst food handlers was also
one of the most commonly reported practices that gave rise to food borne illness (Collins ,1997).
This shows that if food handlers take serious note on the cleanliness of their hands, bodies and
clothing‟s, incidence of cross-contamination will be reduced.
15
2.7 Environmental Sanitation
The term “environmental sanitation” has been given various interpretations in different countries
and at different times. In its most restrictive sense, sanitation has been equated with the safe
disposal of human excrement. In many cases, it is used to cover the handling by the community
of the water supply and the disposal of sewage and refuse. But in recent years, it has been
increasingly used to denote the control, generally, of those elements in the environment that
affect or may affect human health. It has also been defined as an adjustment of the environment
for the prevention of disease. Environmental sanitation include various sanitary conditions like
(1) clean and safe water supply, (2) clean and safe ambient air, (3) efficient and safe animal,
human, and industrial waste disposal, (4) protection of food from biological and chemical
contaminants, and (5) adequate housing in clean and safe surroundings also called environmental
hygiene (WHO, 1953).
Access to basic or adequate sanitation is vital for human health, while having a safe, convenient
and private place to defecate is essential for human dignity. Adequate sanitation refers to the use
of a “sanitary facility” in a dwelling or immediate vicinity. A sanitary facility is a unit for the
disposal of human excreta that isolates feces from contact with people, animals, crops and water
sources. The basic sanitation is the lowest-cost option for securing sustainable access to safe,
hygienic and convenient facilities and services for excreta and sullage disposal that provide
privacy and dignity while ensuring a clean and healthy living environment both at home and in
the neighborhood of users.” This definition captures the relationship between sanitation and
human health and highlights that dignity and privacy are important elements of basic sanitation,
as these promote the use of sanitary facilities (WHO, 2009).
2.8 Education
Education means learning knowledge, skills, and attitudes. The most important of these is
learning how to learn. Learning means deciding about your own lifestyle. Education can be
divided into formal, Non formal and Informal.
16
2.8.1 Formal Education
Non formal education is described as any intentional and systematic educational enterprise
(usually outside of traditional schooling) in which content is adapted to the unique needs of the
students (or unique situations) in order to maximize learning and minimize other elements which
often occupy formal school teachers (i.e. taking roll, enforcing discipline, writing reports,
supervising study hall, etc.). Non formal education is more learner-centered than most formal
education. Learners can leave anytime they are not motivated. Food handlers can obtain
education on food safety non- formally.
The NFE tends to emphasize a cafeteria curriculum of options and choices rather than the
prescribed, sequential curriculum found in schools. In NFE, human relationships are more
informal in which the roles of teachers and students are less rigid than in schools where student
teacher and administrator roles are hierarchical and seldom change in the short term. Non Formal
Education focuses on practical skills and knowledge while schools often focus on information
which may have delayed application. Overall, NFE has a lower level of structure ( Kleis et al,
1973). Most typically, the term or phrase non-formal education is used to refer to adult literacy
and continuing education for adults
Informal Education deals with everyday experiences which are not planned or organized. This is
also refers to as incidental learning. When these experiences are interpreted or explained by
17
elders or peers they constitute informal education (Kleis et al, 1973). Many food handlers
obtained education on food safety through informal and/ or formal education.
18
2.9.2 National Legislations on food Safety
The main national legislations relating to food safety include the following:
1. The Public Health Laws (1917) now known as Public Health Ordinance Cap 164 of
1958;
2. The Food and Drugs Decree, No. 35 of 1974;
3. The Standards Organization of Nigeria Decree, No. 56 of 1971;
4. The Animal Disease Control Decree, No. 10 of 1988;
5. The Marketing of Breast Milk substitute Decree, No. 41 of 1990.
6. The National Agency for Food and Drugs Administration and Control (NAFDAC)
Decree No. 15 of 1993.
The following government organization and agencies are responsible for regulating and
monitoring food safety standards and practices
Federal Ministry of Health has the responsibility for formulating national policies, guidelines and
regulations on food hygiene and safety as well as the monitoring of their implementation. It is
also responsible for establishing guidelines for the requirements for the nutritive value of food,
and monitoring of food environments and handlers, control of food borne disease, the quality of
public water supply as well as national and international matters relating to food.
2.9.4 National Agency for Food and Drug Administration and Control (NAFDAC)
National Agency for Food and Drug Administration and Control is the parastatal under the
Federal Ministry of Health, charged with the responsibility for the regulation and control of
imported and locally processed foods and bottled water, at the Federal and State levels of the
19
government. The agency is involved in controlling the sales and use of foods and to ensure that
foods and food ingredients used in the boarding secondary schools are wholesome and free of
any form of contaminations physical, chemical or microbiological (NAFDAC, 2005).
The amount of time students spend in boarding school varies considerably from one year to
twelve or more years. Boarding school pupils may spend the majority of their childhood and
adolescent life away from their parents, although pupils return home during the holidays. In
United States, schools generally comprise grades seven through twelve, with most covering the
High School years. In Nigeria, boarding school mostly starts from secondary school year one to
six, predominantly children between the ages of 11 to 17 years. However, in Britain, children as
young as 5 to 9 years of age are sending to boarding schools (Power, 2007).
Most societies decline to make boarding school the preferred option for the upbringing of their
children except in former British colonies in India, Nigeria and other African colonies of Great
Britain. This is because children may be spending significant parts of their early life in what
may be seen as total institution and possibly experiencing social detachment. (Goffman, 1948)
20
2.11 School Health
Health is created by caring for oneself and others by being able to make decisions and have
control over one‟s life circumstance and by ensuring that the society one lives creates condition
that allow the attainment of health by all members. The boarding school is an extraordinary
setting through which student‟s health can be improved. Boarding school provides the
opportunity to achieving significant health and educational benefits. The promotion of children
health is recognized at the international level as an important means of influencing health
behavior. The school health has been an important goal of the World Health Organization and
other international agencies and this has gained significant momentum in recent years (WHO,
1999).
School students deserve to inherit a safer and healthier world. It is very important that the school
environment is safeguarded. It is equally important that students have clean water to drink, safe
food to eat, adequate sanitary facilities, adequate water to use for hygiene, clean air to breathe
and safe place to learn and play (WHO, 2003). One of the identified strategies to provide young
people with required knowledge, skill and enabling environment for the development of their
psychological competence is to provide relevant information and education.
There are different categories of schools in Nigeria. There are Nursery, Primary, secondary and
tertiary schools; and about 70% of the schools in Nigeria are owned and financed by the
government (both State and Federal government). Problems associated with the educational
system in Nigeria include the deterioration of the quality of education and inequitable
distribution of facilities nationwide (UNFPA, 1998)
The school environment in most public secondary schools in Nigeria, especially in urban
communities is generally dirty and in deplorable condition which is not conducive to learning
and which is also a potential risk to the food and water consumed by the students and teaching
staff. Many schools do not have dependable sanitary facilities and adequate waste management
system. Many boarding secondary schools lack adequate facilities to properly dispose waste
gathered from the cleaning activities of the students. Udoh (1996) examined the status of health
Education in Nigeria and noted that there is no organized health education in public school
21
system. The curriculum of teaching and learning of health information over the years shows that
the content and methods used concentrate primarily on health information rather than
participation and behavior change among students (Oladimeji and Fabiy, 1993).
The World Health Organization, through the School Health Initiative, promotes the concept of
Health-Promoting School. A Health-Promoting School can be described as a school that is
constantly strengthening its capacity as a healthy setting for living, working and learning. This is
achieved by:
Infectious disease carried by food and water are examples of risks student and school personnel
face at school throughout the world. A school provides for every student an environment that is
physically safe, emotionally secured and psychologically enabling. It also provides protection
from biological, physical and chemical risks that may threaten student‟s health (WHO, 2006).
It was estimated that nearly 5,500 children die each day from bacteria in food, thus unsafe foods
remain an important public health problem in boarding schools. In developing countries, polluted
22
environments, lack of safe water supply and poor sanitation increase the probability of food
contamination. Most food borne disease outbreaks are as a result of improper food handling,
food contamination by equipment, contamination by individuals, cross contamination, use of
contaminated raw food ingredients, use of food containing natural toxins and addition of toxic
chemicals (WHO, 2003).
The global Water Supply and Sanitation Assessment reported that 2.4billon people globally did
not have access to any type of improved sanitation facilities (WHO, 2009). Also, about one sixth
of the global population lack access to adequate drinking water. An estimated 5.3 billion people,
or 83% of the world‟s population, had access to water from an improved source in 2004. While
this is a significant increase from 1990, when the proportion was 78%, the rate of increase has
just barely kept up with population growth. As a result, the proportion of people without access
to improved water sources has not substantially decreased. An estimated 1.1 billion people,
roughly one-sixth of the world‟s population, still do not have access to improved drinking water.
Out of these people, 84% live in rural areas. The global population without access to improved
drinking water is largely concentrated in three regions: Sub-Saharan Africa (322million), Eastern
Asia (302 million) and South Asia (226 million). Overall, the coverage of improved drinking
water is above 78% in all regions of the world, except Sub-Saharan Africa and Oceania, where
the coverage levels are 56 % (WHO, 2007).
23
A much broader definition of basic sanitation that focused on the links between access to
sanitation and human health was proposed by the World Summit on sustainable Development
(WSSD).
Basic sanitation was defined as the lowest cost option for securing sustainable access to safe,
hygienic and convenient facilities and services for excreta and sullage disposal that provide
privacy and dignity while ensuring a clean and healthful living environment both at home and in
the neighborhood of users. This definition captures the relationship between sanitation and
human health and highlights that dignity and privacy are important elements of basic sanitation,
as these promote the use of sanitary facilities (WHO, 2002).
The bacteriological quality of drinking water significantly declines after collection in many
settings. The extent of contamination after water collection in schools varies considerably, but is
proportionately greater where fecal and total coliform counts in source water are low. Low
quality water exposes students and staff of boarding schools to a variety of food and water borne
diseases.
The assessment of Microbiological quality of water involve one or more of the following three
bacteria indicators: (1) total coliform which are Gram-negative bacteria that ferment lactose at
35–37°C within 24–48 h; (2) fecal thermo-tolerant coliform which are a subset of total coliform
bacteria that ferment lactose at 44–45°C and (3) E. coli which are exclusively fecal in origin, are
a sub-group of the fecal coliform that produce the enzyme B-galactosidase and not urease.
Microbiological contamination of water between source and point-of-use is widespread and often
significant. The World Health Organization guidelines state that none of these bacteria should be
detectable in a 100-ml water sample (WHO, 1997). Out of these bacteria, E. coli are regarded as
the most reliable indicator of fecal contamination and total coliform as the least reliable
indicator. A separate analysis was performed for each of the three indicator organisms because
their abundance in water and their origins may be different. For example, total coliform are
known to originate from decaying vegetation whereas E. coli are not and consequently patterns
of contamination may vary between the three types of organisms. Furthermore, total coliform
are more numerous than fecal coliform, which are more numerous than E. coli and so bacteria
24
counts vary for each indicator. „High‟ and „low‟ bacteria count studies are analyzed separately
because the method of assessing the change in water quality was different for these two types of
study.( Mazengia et al, 2002).
According to the World Health Organization, “safe water” is water that does not pose any
significant risk to health over a lifetime of consumption. Safe water is suitable for domestic use,
is free of objectionable tastes and odors and is available in sufficient quantities for hygiene
purposes. Similarly, “safe food” is defined as food that will not cause harm to the consumer
when it is prepared and/or eaten according to its intended use. The Codex Alimentarius defines
“hazard” as a biological, chemical or physical agent with the potential to cause adverse health
effect. For students and staff of boarding schools to be safe, both food and water should not
contain any biological, chemical or physical agents at concentrations directly detrimental to
health. Safe food is achieved when all conditions and measures necessary to ensure the safety
and suitability of food at all stages of the food chain are present and being applied.
This understanding of safe food and water takes into account the varying vulnerabilities that may
occur as people move through different stages of the life-cycle. For example, infants and young
children, as well as the elderly, are more vulnerable to the effects of unsafe food and water often
suffering greater adverse consequences compared to young or middle-aged adults. Students who
are malnourished or living in boarding school facility with unsanitary conditions are also more
vulnerable than those who are well-nourished and/or living in boarding school with hygienic
conditions
25
2.17 Food handlers
A food handler is defined as any person who handles or prepares food and drinks whether
unwrapped or packaged (UKDH, 1997). Therefore, the cook, food servers and food janitors that
work in the school kitchen can all be described as food handlers. Food is handled by the food
handlers in the boarding schools. The food handler may be a cook, food server or food janitor.
.
Food handlers in the course of their normal routine work come into contact with uncovered food
that is not intended for their personal use. . A food handler can broadly be described as any
person involved in the processing, production, manufacturing, packaging, preparation, sale or
serving of any food stuff, including water and beverages. Food handlers are often implicated
when there is food safety compromise or in case of any other food borne illnesses. The most
commonly reported food preparation practices that contributed to school-related outbreaks were
improper food storage and holding temperatures and food contaminated by a food handler and
despite an increase in the number of food handlers receiving food hygiene training, a high
proportion of food poisoning outbreaks still occurred as a result of poor food handling practices
The personal hygiene of food handlers is an essential determinant of the overall safety of food in
the boarding school. Food handlers are meant to be well-groomed and demonstrate high personal
cleanliness. They must wear appropriate hair restraints and should be encouraged to wash hands
thoroughly with warm soapy water before commencing the cooking or handling of foods.
Effective hand washing involves the use of warm water and liquid soap. A good lather is worked
up at least for 20 seconds, while ensuring that wrist, hand, finger, thumb, finger nail and in
between the finger nail are all thoroughly washed. The soap is rinsed off the entire hand and
dried thoroughly using disposable towels or hot- air dryer and never use apron. Food handlers
should never use food preparation sinks for hand washing. Food handler with the following
conditions will require a medical treatment and subsequent certification by medical personnel
before being allowed to handle food. The health conditions are:
Chronic suppurative conditions, e.g. otitis media with drum perforation;
Chronic bronchitis with productive, purulent sputum
Widespread chronic skin conditions, such as psoriasis or eczema which makes skin
cleansing difficult and are often associated with secondary infection.
26
2.18 Bacteria food contaminants
Bacterial infection and poisoning which result from the ingestion of bacteria contaminated food
is commonly referred to as food borne illness.
A more accurate term would be food borne bacterial illness or disease. Most types of “food
poisoning” are strictly not poisoning even though in the final analysis, the symptoms may be
indistinguishable from poisoning. Most food poisoning are really infectious which is the illness
caused by the multiplication of pathogenic microorganism in the living host particularly the
gastro intestinal tract. The term poisoning is applied to these illnesses and is recognized as such
by the general public because of the acute or the severity of the symptoms i.e. the disease occurs
suddenly and in most cases is of short duration. The food borne bacterial illness is strictly the
ingestion of toxin. Most food borne diseases are enteric in nature i.e. the initial early symptoms
are some form of gastro intestinal tract disturbance such as nausea, vomiting, abdominal pain/,
cramp or diarrhea.
There are five major sources of bacteria causing food borne illness.
Fecal matters and /or urine infected human and animal not only those showing symptoms but
also active asymptomatic carriers
Nasal and throat discharges of sick individuals asymptomatic carriers
Infection of body surfaces of food handlers head and arm
Infected soils, mud, surfaces, waters, dust etc
Sea water, marine materials and marine life.
In most food borne diseases, the food serves only as a vehicle of transmission, the final link in
the chain of infection. The food product not only permits the survival of the pathogen, it may
also provide a suitable medium for the rapid proliferation of the microorganism and the
production of toxins as in case of exotoxin producing organisms. The degree to which these
parameters are made possible by the infected food products may determine the final
infectiousness of those products, the severity of the symptoms and the extent of outbreak or
epidemic e.g. cholera causing organisms (Vibro cholera) in acid foods and survives only a few
27
days in many other types of food products. Thus the outbreak of cholera may not occur when
only those types of food are affected ( Felsenfeld, 1965)
The Majority of Cases of Food Poisoning are due to Bacterial contamination. The
microorganisms often implicated include:
The isolation of B. cereus from all the cooked food samples is of concern. This could be
explained by the ubiquitous distribution of this organism and its ability to form endospores
(Mckillip, 2000). The presence of B. cereus in food could be attributed to the methods of
processing the grains (drying on inadequately clean floors count of the food was higher than
counts of the food before heat treatment. According to Wogu et al (2011), four bacteria were
isolated from ready to eat rice sold in Benin City Nigeria. These are: Bacillus cereus,
Staphylococcus aureus, Escherichia coli and Klebsiella pneumonia. Bacillus cereus, which is
mainly associated with food poisoning because of its ability to produce toxins, was present in
37.5% of samples, alongside E. coli. Also, oranusi et al (2007) observed that the hazards
associated with foods prepared in the schools studied were the inadequate (5 - 10 min)
time/temperature exposure of foods (akamu, tuwo, eba), extensive handling of foods by cooks
after preparation, leaving cooked foods open till served to students and the presence of toxigenic
strains of B. cereus and E. coli.
28
The International Commission on Microbiological Specification for Food (ICMSF) 2002
suggested the acceptable limit for B. cereus in food to be 3 log10cells/g, with 4log10/g as
tolerable and above 6log10/g as above the acceptable limit. The optimum growth temperatures
for B. cereus are 30 to 35°C (Breed et al.1957). The maximum temperature permitting growth is
between 40°C and 50°C depending on the strain (Kim and Goepfert, 1971)
The minimum temperature permitting growth of B cereus in food is between 10°C to 12°C
(Larkin and Stokes, 1966). . Heat may influence the germination of B. cereus by the direct effect
on the spores and effect on medium (Davies and Wilkinson, 1973)
Human are the most important single source of staphylococcus contaminant of food products.
Food handlers are probably the most important single source of staphylococcus contaminated
foodstuffs. For example, sources of staphylococcus in several cases of serious and widespread
outbreak of food poisoning in England were constantly traced to persons involved in preparation
of contaminated stuffs In most cases, persons involved in food disease outbreaks were active
nose and hand carrier. The carriers disperse staphylococcus to their surroundings from the nose
and especially the skin (Hobbs et al, 1968).
The role of food handlers in the contamination of food products is illustrated by the outbreak of
staphylococcus food poisoning in Colorado USA. In this particular outbreak, Greek spaghetti
dispensed in vending machine was the vehicle. Meat used for the dish was handled by an
employee with blisters and bandage on his hand which was shown to carry a couagulase positive
staph aureus phase 85. This strain was also present in the Greek spaghetti in the vending machine
and the raw meat used in the preparation. Type D enterotoxin was found in the food even though
staph. aureus phase type 85 produced only type A enterotoxins. This is an indication that at the
29
time of the outbreak, the strain had overgrown the original strain which produced type D
enterotoxins (CDC, 2000). The staphylococcal aureus infection is a staphylococcal food
poisoning caused by enterotoxin producing strain of staphylococcus aureus. This is one of the
common food borne illnesses and the leading cause of food poison in Ambrose Ali University of
Nigeria and it‟s environ.(Oni et al, 2010)
As early as the mid-1950's, antibiotics were being fed to farm animals for the purpose of faster
weight gain with less feed. The effectiveness of antibiotics for this purpose has never been
proven while this procedure was not for the purpose of disease control. Outbreaks of E. coli
0157; H7 began occurring in the US in 1982 and have been happening since then at even more
alarming rates.
The coliform bacteria group consists of several genera of bacteria belonging to the family
enterobateriaceae. The bacteria are mostly harmless and live in soil, water and the digestive
system of animals. Fecal coliform bacteria, which belong to this group, are present in large
numbers in the feces and intestinal tracts of humans and other warm-blooded animals, and can
enter water bodies from human and animal waste. If a large number of fecal coliform bacteria
(over 200 colonies/100 milliliters (ml) of water sample) are found in water, it is possible that
pathogenic (disease- or illness-causing) organisms are also present in the water. Fecal coliform
by themselves are usually not pathogenic; they are indicator organisms, which means they may
indicate the presence of other pathogenic bacteria.
30
2.24 Food Safety Practices of Food Handlers
Musa et al, (2003) investigated Food hygiene practices of food vendors in secondary schools in
Ilorin Nigeria. The researcher observed that the major unhygienic practices observed among the
food handlers were poor care of used utensils, use of previously used water for washing and
cleaning, lack of covering apron among the food handlers and lack of wash hand basin for
immediate cleaning. Only 85(46%) of the respondents used soap and water to clean their utensils
while the rest 100(54%) used unhygienic methods to clean their utensils. It was observed that the
food handlers who used soap and water for cleaning, vended food at locations that were
relatively closer to water source, compared to other food handlers who used other methods to
clean their utensils. Unkempt fingernails, skin lesions and poor food protection from flies were
some of the food contaminating risk factors observed in the study
Mejayi, H (2011) investigated the microbiological quality of foods sold in secondary schools in
Abeokuta, Ogun state, Nigeria and indicated that students are prone to food borne diseases due
to high levels of food contaminations in the secondary schools studied. The researcher attributed
the high level of microbial contamination to the absence of regulation and guidelines for food
handlers on food hygiene practices. The researcher further suggested that the microbial
contamination may have been introduced by the food handlers through various unhygienic
practices.
Ekwenye et al, (2005) reported that most food handlers had undertaken formal food hygiene
training; however, many who had no food hygiene training still handled food . On-going
supervision and pre-training support was lacking and this limits the effectiveness of the food
hygiene training. The researcher further suggested that there are evidence for a causal link
between hand washing and risk of infection from the food prepared by food handlers and that
subjective norm is the most significant influence on food handler‟ intention to perform safe food
handling practices regardless of the training status of the food handlers.
Oranusi et al, (2007) evaluated food safety in boarding schools in Zaria, Nigeria, using the
HACCP system. The researcher observed that all the foods (akamu, eba, tuwo and vegetable
soup) attained cooking temperatures of 60 – 100°C which was capable of destroying vegetative
31
forms of food borne pathogens. However, B. cereus, Staphylococcus aureus and coliforms were
isolated in the cooked foods. The researcher further suggested that high level initial
contamination associated with raw foods, food ingredients, food contact surfaces, food handlers
and inadequate cleaning of food utensils call for concern..
32
CHAPTER THREE
METHODOLOGY
33
3.3 Sampling Methods
To ensure adequate representation of all schools with boarding facility in Ibadan, a list of all
boarding schools in Ibadan was obtained from Oyo State Ministry of Education. There were
fourteen public secondary schools that were officially identified to have a boarding facility. Of
this number, only twelve schools physically have boarding facilities. Using stratified random
sampling, twelve schools were grouped into three strata based on the location of the public
schools in the three Ibadan zonal areas followed by a simple random sampling method to
randomly select five public boarding secondary schools after which the sixth school selected
declined participation.
The selected five public secondary schools are:
1. St Louis Grammar School Mokola, Ibadan (SLGS)
2. Command Secondary School Bodigbo Ibadan (CSS)
3. The International School, University of Ibadan ( ISI)
4. Queen School Apata, Ibadan (QSI)
5. Government College , Ibadan (GCI)
34
3.4.4 Exclusion Criteria
Food handler in the selected schools that is not willing to participate.
Private boarding secondary schools in Ibadan.
Public secondary schools in Ibadan without boarding facilities
All samples were collected in sterile sample bottles containing sterile 0.1% peptone water using
sterile metal spoons. Moi moi and akamu were collected in the morning during breakfast, while
vegetable soup, rice and yam porridge were collected during lunch. Time between sample
collection and analysis did not exceed 6 hours. The food samples were placed in a light-proof
insulated box containing ice-packs to ensure rapid cooling. The samples were kept in the dark.
Food samples were tested for coliform, Bacillus cereus, Staphylococcus aureus and Escherichia
coli. The food preparation areas for the five selected schools were observed. Time of food
holding i.e. from the time foods were dished to the time they were eventually eaten was
recorded. Food temperatures were taken during holding just before consumption. This was done
by inserting a thermocouple into the central region of the food being served. The duration of
food holding was recorded using stop clock. The microbial analysis of food samples was carried
out following standard methods.
35
3.5.2 Water sample collection
Two water samples were taken from different locations in each of the five schools. Samples
were collected from Tap connected to Borehole, Well, drinking water container and washing
water bowl. Water samples were poured into sterile sample bottles with screw caps. Time
between sample collection and analysis did not exceed 6 hours. Water samples were placed in a
light proof insulated box containing ice-packs to ensure rapid cooling. The samples were kept in
the dark. Water analysis was mainly bacteriological involving detection of coliform. Physical
parameters such as color, odor, taste and smell of water samples were also determined. Microbial
analysis of water samples was carried out following standard methods.
36
The number of colonies on the agar plate was counted afterwards. This was expressed as the
number per ml of sample. According to the WHO (1997) standards, the Total coliform, Fecal
coliform and E. coli should be absent from drinking water
37
The number of positive tubes (those with gas production and color change) were counted
after incubation for 24 hours for each dilution.
A consecutive series of 3 ten-fold dilutions which shows some positive and negative
reactions were selected.
The result was reported in terms of the most probable Number (MPN) of the total coliform
present in 100ml of water sample estimated from the MacCrandy‟s statistical table.
38
3.5.9 Procedure for Confirmed test
The content of each of the positive tube was sub cultured into peptone water in a test tube
using an inoculating loop
These were incubated in incubator at 44°C for 18-24 hours
After the incubation, about 2 drops of kovac‟s reagent was added using Pasteur‟s pipette. A
ring brown solution at the upper layer of test tube is indicative of a positive reaction and then
a probable presence of E. coli.
39
boarding school and validated before being administered to each food handler. A Face-to-face
interview was conducted in English and Yoruba (the language widely spoken in the study area)
to ensure good understanding. Written and signed informed consent was sought from each
respondent. The purpose of the study was explained to each participant that the information
provided will be kept confidential and that the participation is voluntary.
40
shown in appendix 2. The hygiene conditions of the kitchens, toilets and dinning of the boarding
schools were assessed by direct observation using 30-item checklist with mean scores of
≥70%, 50-69%, 40-49% and <40% categorized as excellent, good, fair and poor hygiene conditions
respectively.
Plate 3.2: Food handlers in action without wearing protective apron and head covering
41
Plate 3.3: Food handlers exposed to smoke and heat from firewood method of food preparation
42
3.6.4 Statistical analysis and Data management`
The qualitative data obtained from the onsite observation and observation checklist were
summarized while the quantitative data obtained through questionnaire, microbiological analysis
of food and water, food holding temperature were recorded and analyzed with Statistical
Package for Social Sciences(SPSS) version15 while a coding guide was utilized to facilitate data
entry. The quantitative data were first summarized with descriptive statistics such as mean, mode
and standard deviations while inferential analysis such as the independent samples t-test and chi-
square were used to test for the significant difference and significance of association
respectively. The degree of freedom or levels of significance were also stated. Data analysis
results are presented in charts, tables and figures in result section.
43
CHAPTER FOUR
RESULTS
This chapter presents the description of demographic characteristics of food handlers, food
handling practices, food training, and knowledge attitude and practices on food safety, on site
observation and sanitary conditions of kitchen, toilet and dining. This is shown by the data from
the socio demographic information, food handlers‟ education on food safety, food holding
temperature, environmental sanitation practices and food safety knowledge and practices
obtained from the questionnaire survey, observation checklist and In-depth Interview. The results
on microbiological analysis of food and water and Mean holding temperatures of food are also
presented. The analyses of results were grouped into three sections. The first section assessed
food safety practices and KAP of food handlers on food safety; the second section analyzed
microbiological growth on food and water and food holding temperature while the third section
presents analysis of environmental sanitation and results of in-depth interview.
A total of 59 food handlers: SLGS (8), QSI (9), GCI (6), ISI (19) and CSS (17) participated in
this study with 13 (22%) male and 46(78%) female. Those that were married were. 37(62.7%)
while 22 (37.3%) were single. Forty-five (76.3%) of food handlers that participated were less
than 40 years of age while (2)3.4% were adult of 60 years and above. Fifty one (86.4%) of the
food handlers are Christian while 8(13.6%) practice Islamic religion. From the total number of
food handlers, 52(88.1%) were cooks while 7(11.9%) were food servers whom although handle
food, do not participate in actual cooking of food (Table 4.1). Furthermore, about 38 (64.4%) of
the food handlers have secondary education, 5 (8.5%) had tertiary education, while 6(10.2%) of
the handlers had no formal education at all (Table 4.1).
44
Table 4.1: Socio-Demographic Characteristics of the Food Handlers
Factors Categories N %
Gender Male 13 22
Female 46 78
Age
20-29 19 32.2
30-39 26 44.1
40-49 8 13.6
50-59 4 6.8
>=60 2 3.4
45
4.2 Food Safety Education and Training
The food handlers are exposed to a form of training at the commencement of employment as
food handler and from time to time to keep them abreast of the challenges of food safety. Fifty
three (89.9%) of the respondents claimed to have had training on food safety while 6(10.2%)
food handlers did not have any form of food training. Of the food handlers that reported to have
had food training, 14(26.4%) had on the job training, 6(11.3%) had formal health training with a
proof of certificate, 24(45.3%) had informal training on food safety with no certificate, while
9(17.0%) had only attended special food safety training organized by their employers. (Table
4.2)
46
Table 4.2: Food safety Education and training of food handlers
Categories N (%)
No 6 (10.2)
47
4.3 Medical Examination of food handlers
48
Table 4.3: Medical Examination of Food Handlers
Variables Categories N (%)
49
Table 4.4.: Water facilities in the schools
N (%) N (%)
50
4.4.2 Sewage and Refuse Disposal Methods in Schools
The toilet facilities food handlers‟ use in the five selected schools was poorly maintained and
grossly inadequate. The toilet environment was full of flies and offensive odor. The 5 schools
had poor sanitary conditions with no running water or effective excreta disposal system. Majority
of the respondents reported that toilet facilities in their school were inadequate while food
handlers at Government College Ibadan had no toilet facility and so they defecated in the nearby
bush.
The five schools claimed to have 3 main refuse was disposal types: Refuse was disposed in open
field, dump site and pit. Although refuse disposal in the majority of the schools were inadequate,
Thirty- four (57.6%) of respondents said they dump their refuse in open field, 3(5.1%) claimed to
deposit waste in a dump site while 22 (37.3%) of respondents dump their solid waste into pits
provided by the schools. Also, there are different types of excreta disposal methods in the
schools. Forty- five (76.3%) food handlers claimed to use pour flush, 6(10.2%) use septic tank,
1(1.7%) use pit latrine while 7(11.9%) defecate in the open and throw into bush.(Table 4.5)
51
Table 4.5: Sewage and refuse disposal facilities in the schools
Facilities N (%)
52
4.4.3 Access to water source, sewage and refuse disposal facilities
Twelve(20.3%) food handlers reported that they walked 3 minutes(0.3km) or more in order to
fetch water for drinking and cooking while 47(79.7) of respondent said they walked less than 3
minutes(0.3km) to obtain water for cooking, drinking and general cleaning for food preparation.
Forty- one(69.5%) of the food handlers claimed to walk less than 2 minutes(0.2km) to the
excreta disposal facility while 18(30.5%) reported to work more than 2 minutes(0.2km) to access
excreta disposal facility. Also, 17(28.8%) of food handlers reported walking less than 2(0.2km)
minutes to get to the refuse disposal point, 35 (59.3%) said they walked between 2 -
5minutes(0.3km) while 7 (11.9%) walked more than 5 minutes(0.5km) just to dump the
refuse.(Table 4.6)
53
Table 4.6: Access to water source, sewage and refuse disposal facilities
Min km
54
4.5 Domestic animals in cooking area
The major sources of microbial contamination in food are human being and animals Thus 18
(30.5%) of the food handlers reported having domestic animals like goat, chicken, sheep ,cat etc
around the food preparation areas , while 41(69.5%) claimed to have no domestic animals around
the food preparation areas.(Table 4.7)
55
Table 4.7: Domestic animals in the food preparation area
Categories %
Domestic animals present 18 30.5
Domestic animals absent 41 69.5
Total 59 100.0
The domestic animals include cats, sheep, chicken, goats, cattle, sheep,
56
Figure 4.1 Methods of pest control in schools
57
Table 4.8: Food preparation and storage
Categories N %
Food preparation place(kitchen) is separated from Yes 45 76.3
Storage place(store) No 14 23.7
Raw food are stored separately from cooked food Yes 39 66.1
No 20 33.9
58
32%
Firewood
68% Bottled gas
59
4.9 Food holding temperature
Majority of the foods prepared in the five boarding schools attained temperatures of boiling or
near boiling of 60 – 100°C, thus no serious food temperature breach was recorded. However,
Akamu seems to have an average holding temperature of less than 50°C. The mean holding
temperatures in degree centigrade for all foods in each school were: SLGS (51.9±9.9), CSS
(51.2±12.0), and ISI (64.8±5.5), QSI (48.9 ±12.7 and GCI (55.2±10.0) with the total mean food
holding temperature of 54.6 ±11.4 (Table 4.9).
The result also revealed that in all the schools, mean holding temperatures of food in degree
centigrade were: Rice (57.4±4.6), moi-moi (57.1±5.9), “akamu” (34.3±1.5), vegetable-soup
(59.0±6.7) and Yam-porridge (63.4±3.6). The average temperature at which akamu was
consumed in all the five boarding schools was below the recommended food temperature of hot
ready- to- eat food. (Table 4.9.1) There is a significant difference between food holding
temperature among the five boarding schools (P<0.05). Also it was shown that there is
significant difference between the foods holding temperature in all schools and the USFDA
standards (P<0.05) (Tables 4.9.2).
60
Table 4.9: Mean holding temperature of foods in the schools
61
Table 4.9.1: Mean holding temperature of each food in the schools.
Food Temp(oC)
SLGS 65 43 64 61 68
CSS 64 36 57 60 -
ISI 60 - - 68 69
QSI - 28 57 56 66
GCI 62 30 58 58 68
62
Table 4.9.2 Mean difference between the foods holding temperature in all schools and the
USFDA standard
Standard
temperature 60.0
63
4.10 Food holding time
The mean holding time which is the time between food preparation and the actual consumption
of food is a very crucial determinant of food safety. The result revealed that there was no serious
food holding time breach in all the five schools studied since none of the school held food for
more than 3hours before consumption. The mean food holding time in minutes for each food
prepared in the 5 schools were: Rice(36min.3sec) akamu(,43.5min) moi moi(36min), vegetable
soup(41min),and yam pouridge(30min.5sec). St Luis Grammer School Mokola had a significant
higher food holding time (48min) than all other schools and surprisingly the same school had the
lowest food holding time(27min) recorded. Majority of the food prepared in the five boarding
schools were consumed within 27min to 1hour after preparation hence no serious time –
temperature breach was recorded. (Table 4.10)
64
Table 4.10: Mean food holding time in schools
Food holding time(min)
SLGS 45 48 45 45 27
CSS 35 40 30 40 -
ISI 30 - - 40 30
QSI - 46 35 40 35
GCI 35 40 40 40 30
65
4.11 Microbial Quality of food and water
The microbiological analysis of water samples collected from the schools showed the presence
of Total coliform, fecal coliform and E.coli while the microbial analysis of food samples
indicated the presence of B.cereus, E.coli, Staph aureus and fecal coliform.
In all the schools, rice had the lowest number of microbial count. Fecal coliform (5.0×108 cfug1)
recorded the highest microbial count found in rice while staph aureus was not detected in all the
rice prepared in the five schools. The fecal coliform count of Akamu at CSS (5.1×108), QSI
(5.1×108) and GCI (5.0×108) were very similar. However, Fecal coliform was not observed in
akamu at ISI and SLGS.
The E. coli count in Akamu was highest for GCI (7.5×108), followed by QSI (4.6×108) with the
least count of 3.7×108 cfug-1 recorded in SLGS. Staph aureus was not detected in moi moi
prepared in SLGS, QSS and GCI, likewise no growth of E. coli was detected in moi moi
prepared in STLG, CSS and GCI. Apart from the B. cereus found in the vegetable soup
(4×108cfug-1), no other food samples tested positive for B.cereus in ISI. However, QSI recorded
the highest microbial counts of B.cereus (1.8×109), Staph aureus (1.4×109), E.coli (, 7.5×108) and
Fecal coliform (5.3×108)in all the foods prepared in the five boarding schools. (Table 4.11.1)
66
Table 4.11: Microbial load of foods prepared in selected public secondary schools with
boarding facilities in Ibadan
Organism School Rice Akamu Moin-moin Vegetable soup Yam porridge
(cfug-1) (cfug-1) (cfug-1) (cfug-1) (cfug-1)
B cereus SLGS 3.1×108 1.4 ×109 4.7×108 1.4×109 3.4×108
CSS 3.6×108 1.5×109 2.0×108 5.0×108 NT
ISI ND NT NT 4×108 ND
QSI NT 1.8×109 4.3×108 5.1×108 5.2×108
GCI ND 1.5×109 ND ND 1.8×109
Staph aureus SLGS ND NT ND ND 5×103
CSS ND ND NT 1.5×108 NT
ISI ND NT NT 1.3×108 ND
QSI NT 2.3×108 ND 0.5×109 1.4×109
GCI -ND 1.6×108 ND ND 1.0×108
E.coli SLGS ND 3.7×108 ND 3.7×108 3.1×108
CSS 2.2×108 4.0×108 ND 2.7×108 NT
ISI ND NT NT 2.3×108 ND
QSI NT 7.5×108 3.9×108 4.0×108 4.3×108
GCI ND 4.6×108 ND 1.2×107 ND
Feacal coliform SLGS ND 4.9×108 4.8×108 5.1×108 ND
8 8 8
CSS 5.0×10 5.1×10 Nd 4.9×10 NT
ISI ND NT NT ND ND
QSI NT 5.1×108 4.8×108 5.2×108 5.3×108
GCI 5.1×108 5.0×108 Nd ND 5.3×108
ND = Organism not Detected; NT = Organism not Tested
67
4.13 Microbial quality of water
According to the WHO and SON standard limits for water safety level, Total Coliform and E.
coli should be absent in drinking water (WHO, 1997). The drinking water samples collected
from SLGS had Total and fecal coliform of 11 and 10 MPN/100mls respectively. These values
are higher than the permissible limits although the E.coli value was within the permissible limits.
At QSI, the drinking and cooking water samples had E. coli values of 2 and 4 MPN/100mls
respectively. This values are higher than the acceptable limits hence the water is not safe for
consumption. Total and fecal coliform of 20 and 9MPN/100mls respectively for drinking water
collected from CSS were higher than the recommended limits; E. coli was not present in the
water. The drinking water in CSS was however less polluted compared to the QSI with drinking
water of 20, 9 and 2 MPN/100mls for Total, fecal coliform and e. coli respectively.
Drinking water samples at GCI was the most polluted of the drinking water in all the schools
with the Total and fecal coliform values of 23 MPN/100mls, while ISI recorded the lowest total
and fecal coliform contamination in drinking water of 6 and 4 MPN/100 respectively. This lower
contamination of drinking water may be due to the fact that water was boiled, filtered and then
dispensed through a potable water dispenser at ISI. (Table 4.12)
Going by the results obtained in all five schools, it was shown that the drinking water in all the
schools were unsafe for consumption because virtually all the water samples contained fecal
coliform and total coliform and some also had E.coli above the limits recommended by SON
and WHO. Although, none of the drinking water in the five boarding schools was safe for
consumption, the cooking water could still be used since it would eventually reach the boiling
temperature and thus make the food safe for consumption.
68
Table 4.12: Microbial quality of water in selected public secondary schools with boarding
facilities in Ibadan
69
4.14 Knowledge Attitude and Practice on food safety
The analysis of the questionnaire results show that the mean KAP scores of food handlers on
food safety was 26.9±4.9, 13.4±3.2 and 21.9±3.8 out of total score of 40, 24 and 30 respectively.
Among the food handlers, 78%, 5% and 83% had a good Knowledge, attitude and practices on
safe food storage respectively while 22%, 95% and 17% of food handlers need improvement on
their knowledge, attitude and practice on food storage respectively. From the statistical analysis,
there was a significant relationship between knowledge and practice on safe food storage and
between attitude and practice on safe food storage (p<0.05) (Table 4.13).
The result also showed that among food handlers, 73%, 19% and 48% had a good knowledge,
attitude and practices on hand wash respectively while 27%, 81%, 52% of food handlers need
improvement on their Knowledge, attitude and practices respectively on hand washing . In
addition, there was no significant relationship between food safety knowledge and practice on
hand washing and between food safety attitude and practice of hand washing among the food
handlers. (Table 4.14)
Furthermore, 34%, 37% and 36% of food handlers had a good level of knowledge, Attitude
and Practices respectively on food storage temperature , while 66%, 63%, 64% of food handlers
need improvement on their knowledge, attitude and practices on food safety temperature. Also,
there was no significant relationship between food safety knowledge and practice on food
temperature and between food safety attitude and practice on food temperature among food
handlers. (Table 4.15)
70
Table 4.13: KAP of food handlers on food storage
Indicators N (%)
Knowledge of food storage
Good 46(78)
Needs improvement 13(22)
Attitude on food storage
Good 3(5)
Needs improvement 56(95)
Food storage practice
Good 49(83)
Needs improvement 10(17)
71
Table 4.14: KAP of food handlers on hand washing
Indicators N (%)
Knowledge of hand washing
Good 43(73)
Needs improvement 16(27)
Attitude on hand washing
Good 11(19)
Needs improvement 48(81)
Hand washing practice
Good 28(48)
Needs improvement 31(52)
72
Table 4.15: KAP of food handlers on food temperature
Indicators N (%)
Knowledge of food temperature
Good 20(34)
Needs improvement 39(66)
Attitude on food temperature
Good 22(37)
Needs improvement 37(63)
Food temperature practice
Good 21(36)
Needs improvement 38(64)
73
4.15 Knowledge of food safety in relation to Sex, Marital Status, Level of Education and
Age of Food Handlers
According to the results, 8(62%) of male and 24(52%) of female food handlers had good food
safety knowledge, while 5(38%) of male and 22(48%) of female food handlers had poor
knowledge of food safety.(Table 4.17) Also, 12(55%) of single and 20(54%) of married food
handlers had good knowledge of food safety while 10(45%) of single and 17(46%) of married
food handlers had poor knowledge of food safety (n=59)(Table 4.16). Result also shows that
4(80%), 19(58%), 7(47%), and 2(33%) of food handlers with tertiary, secondary primary and no
formal education respectively had good knowledge of food safety while 1(20%), 14(42%),
8(53%) and 4(67%) of food handlers with tertiary, secondary , primary and no formal education
respectively had poor knowledge of food safety.(Table 4.16).The result showed that 18(54%),
11(55%), 3(60%) and none (0%) of food handlers within the age range 20-34,35-49,50-64 and
65-79 respectively had good knowledge of food safety education, while 15(46%), 9(45%),
2(40%), and 1(100%) of food handlers within the age range 20-34,35-49,50-64 and 65-79
respectively had poor knowledge of food safety education(Table 4.16)
74
Table 4.16: Knowledge of food safety in relation to Sex, Marital Status , Level of Education
and Age of Food Handlers
Knowledge of food safety p-value
Marital status
Single 10(45) 12(55) 22(100) 0.971
Married 17(46) 20(54) 37(100)
Level education
None 4(67) 2(33) 6(100) 0.409
Primary 8(53) 7(47) 15(100)
Secondary 14(42) 19(58) 33(100)
Tertiary 1(20) 4(80) 5(100)
Age
20-34 15(46) 18 (54) 33(100) 0.739
35-49 9(45) 11(55) 20(100)
50-64 2(40) 3(60) 5(100)
65-79 1(100) 0 1(100)
75
4.16 Food Safety Attitude in relation to Sex, Marital Status, Level of Education and Age
of Food handlers
The result shows that 5(38.5%) of male and 25(54.3%) of female food handlers had good attitude
on food safety while 8(61.5%) of male and 21(45.7%) of female food handlers had poor attitude
on food safety.(Table 4.17) Also, 12(54.5%) of single and 30(81.1%) of married food handlers
had good attitude on food safety while 10(45.4%) of single and 7(18.9%) of married food
handlers had poor food safety attitude.(Table 4.17) The result also shows that 33(56%),16(49%)
10(67%), and 3(50%) of food handlers with tertiary, secondary , primary and no formal
education respectively had good attitude on food safety, while 26(44%) , 17(51%), 5(33.3%)
and 3(50%) of food handlers with tertiary, secondary , primary and no formal education
respectively had poor food safety attitude.(Table 4.17). Considering the age of food handlers
with respect to the food safety attitude, 16(49%), 13(65%), 4(80%) and none (0%) of food
handlers within the age range 20-34,35-49,50-64 and 65-79 years respectively had good attitude
on food safety , while 17(51.5%), 7(35%), 1(20%), and 1(100%) of food handlers within the age
range 20-34,35-49,50-64 and 65-79 years respectively had poor food safety attitude.(Table
4.17)
76
Table 4.17: Food safety Attitude in Relation to Sex, Marital Status, Level of Education and
Age of Food Handlers
Food safety practice p-value
Poor Good Total
N (%) N (%) N (%)
Sex
Male 8(61.5) 5(38.5) 13(100) 0.351
Female 21(45.7) 25(54.3) 46(100)
Marital status
Single 10(45.4) 12(54.5) 22(100) 0.148
Married 7(18.9) 30(81.1) 37(100)
Level of Education
None 3(50) 3(50) 6(100) 0.439
Primary 5(33) 10(67) 15(100)
Secondary 17(51) 16(49) 33(100)
Tertiary 26(44) 33(56) 59(100)
Age
20-34 17(51) 16(49) 33(100) 0.278
35-49 7(35) 13(65) 20(100)
50-64 1(20) 4(80) 5(100)
65-79 1(100) 0(0) 1(100)
77
4.17 Food safety Practices in relation to Sex, Marital Status, Level of Education and Age of
Food Handlers
The results revealed that, 10(77%) of male and 29(63%) of female food handlers had good food
safety practices, while 3(23%) of male and 17(37%) of female food handlers had poor food
safety practice.(Table 4.18) Also, 12(55%) of single and 27(73%) of married food handlers had
good food safety practice while 10(45%) of single and 10(27%) of married food handlers had
poor food safety practice.(Table 4.18) It can also be deduced from the result that 5(100%),
19(58%), 9(60%), and 6(100%) of food handlers with tertiary, secondary, primary and no formal
education respectively had good practice on food safety, while none (0%), 14(42.4%), 6(40%)
and none (0%) of food handlers with tertiary, secondary, primary and no formal education
respectively had poor food safety practice(Table 4.18). Lastly, considering age of food
handlers with respect to the food safety practices, 17(51%), 16(80%), 5(100%) and 1(100%) of
food handlers within the age range 20-34,35-49,50-64 and 65-79 years had good food safety
practice , while 16(49%) and 4(20%) of food handlers within the age range 20-34 and 35-49
had poor food safety practice.(Table 4.18)
78
Table 4.18: Food safety practice in relation to Sex, Marital Status, Level of
Education and Age of Food Handlers
Variable Food safety practice p-value
Poor Good Total
n (%) n (%) N (%)
Sex
Male 3 (23) 10 (77) 13 (100) 0.351
Female 17 (37) 29 (63) 46 (100)
Marital status
Single 10(45) 12(55) 22(100) 0.148
Married 10(27) 27(73) 37(100)
Level of Education
None 0 6(100) 6(100) 0.073
Primary 6(40) 9(60) 15(100)
Secondary 14(42) 19(58) 33(100)
Tertiary 0 5(100) 5(100)
Age
20-34 16(49) 17(51) 33(100) 0.047
35-49 4(20) 16(80) 20(100)
50-64 0 5(100) 5(100)
65-79 0 1(100) 1(100)
79
4.18 On-site Observations on Hygiene and Sanitary Conditions of Schools
The schools‟ kitchen, toilet, dining hall and personal hygiene of food handlers are essential
parts of the school food environment, and they all play vital roles in the integrity and safety of
the food consumed in the boarding schools. It was difficult to rate the sanitary conditions of
schools‟ kitchens and dining as good or bad due to lack of standard grading tools and/or
reference materials. However, this study selected a few variables to rate the sanitary conditions
of boarding schools in Ibadan as follows: floor repair condition, infestation of flies, toilet
availability, cleanliness, availability of hand washing place in the lavatories, physical condition
of solid waste storage containers, and availability of clean piped water supply.
Food preparation was primarily carried out in an open kitchen for all the selected schools, only
ISI had a closed type kitchen. All other schools prepared food in an open kitchen. This gives
easy access to flying insects such as houseflies, rodents like rats and domestic animals like
chickens, goats etc. Some schools like the CSS, QSI and GCI use the kitchen for storing worn
out materials, food handlers personal belongings, unused cooking utensils etc. As a result, the
kitchen environment in most schools was generally dirty with poor sanitary conditions.
The proximity of the schools kitchen to the toilet facility is of great concern. Most of the schools
toilets except SLGS were situated close to the kitchen. This is of serious environmental health
implications more so that majority of them except ISI had open kitchen which gives easy access
to the flow of bacteria, insects, vermin and other food contaminants. Furthermore, with the
exception of ISI, none of the schools had piped water in the kitchen, hence water was fetched at a
distance and brought to the kitchen in open containers like bowls and buckets.
Visible smoke deposits were seen on the walls and roofs of kitchens in most schools except ISI.
This may be because ISI is the only school that uses the liquefied gas method of cooking while
other schools use firewood for cooking. The solid waste receptacles at the kitchen were not
properly secured(Table 4.19)
80
Table 4.19 Sanitary/Hygiene Conditions of Kitchens in Schools
Food is prepared inside the kitchen Yes Yes Yes Yes Yes‟
Kitchen is used to store worn out materials, No‟ Yes No‟ Yes Yes
firewood etc
Domestic animals seen in and around the Yes No No‟ No‟ Yes
kitchen
Kitchen is just by the toilets or latrine No‟ Yes Yes Yes Yes
Bowls and/or buckets are used for dish washing Yes Yes No‟ Yes Yes
Presence of visible smoke particles on the Yes Yes No‟ Yes Yes
walls
Presence of insect vectors e.g. cockroaches, Yes Yes Yes Yes Yes
houseflies.
97
Kitchen Floors Concrete‟ Plain earth Concrete‟ Concrete/Plai Concrete/Plain
n earth earth
Window that could be open (an average of No window No window Yes‟ No window No window
10% of the floor area)
Key:
Excellent (≥70%), Good (50-69%), Fair (40-49%), Poor (<40%).
98
4.20 Sanitary/Hygiene Conditions of the Toilets in Schools
Food handlers at CSS, ISI and SLGS use septic tank type of toilet, while those at QSI utilize pit
latrines. There was no toilet facility available for the food handlers at GCI hence the food
handlers made use of the surrounding bush for defecation. None of the schools had piped water
available in the toilets however; all except GCI made use of mobile water container which could
be refilled when needed.
The toilet floor of all the schools except ISI was water flooded, none of the schools had washing
fluid available in the toilet, hygiene conditions of toilets in all the schools was generally bad
while food handlers at ISI, GCI and CSS use toilets as storage for worn out materials, old items
and food handlers‟ clothing. (Table 4.20)
99
Table 4.20 Sanitary/Hygiene Conditions of Toilets in Schools
Toilet also stores worn out materials, clothes and old No Yes Yes Yes No
items
Key:
Excellent (≥70%), Good (50-69%), Fair (40-49%), Poor (<40%).
100
4.21 Sanitary/Hygiene Conditions of the Dining in Schools
All the five schools had dining hall which can sit all students at once except CSS and SLGS
where the students had to take meal in batches because of limited space. The floor and walls at
QSI, CSS and GCI are dirty while parts of the roof of dining at GCI and QSI had already fallen
off. There was adequate ventilation in the dinning of most schools with walls and ceiling in good
conditions except for GCI and QSI. (Table 4.21)
101
Table 4.21 Sanitary/Hygiene Conditions of Dining in Schools
Environmental Health indicators Schools
of the dining hall SLGS CSS ISI QSI GCI
Dining hall available Yes Yes Yes Yes Yes
Dining hall sit all students at meal time No No Yes Yes Yes
Key:
Excellent (≥70%), Good (50-69%), Fair (40-49%), Poor (<40%).
102
4.22 Personal Hygiene of Food Handlers in Schools
About 50% of food handlers at SLGS and QSI, 90% at ISI, less than 10% at CSS and none at
GCI were seen wearing protective head covering during food handling. About 50% of food
handlers at SLGS and QSI, 70% at ISI, and none from GCI wear safety apron. Food handlers
were seen with untrimmed long nails, conspicuous ring and other hand ornaments and less than
50% of the food handlers at ISI, CSS, GCI and QSI washed hands before cooking. About 50% of
food handlers at QSI sneeze without hand washing. Almost every food handler at SLGS washed
hands before food preparation. This was however different at CSS, ISI and GCI where food
handlers forgot to wash hands before starting food preparation.
Although few food handlers were seen picking nose during food preparation, this unhygienic
practice was common with food handlers at SLGS and GCI with 50% of food handlers pick nose
without hand washing during food preparation. The nose picking practice was however not
observed with food handlers at CSS and QSI. None of the food handlers at SLGS and QSI kept
long untrimmed nails while more food handlers about 33% at GCI and 25% at CSS had long
fingernails and 8% of handlers at CSS had dirty fingernails (Table 4.32)
103
Table 4.22 Personal Hygiene of Food Handlers in Schools
Personal Hygiene of Schools
Food Handlers SLGS CSS ISI QSI GCI
hand washing
100 0 100 0 0
Total (%) 50 14 37 31 22
Key:
Excellent (≥70%), Good (50-69%), Fair (40-49%), Poor (<40%).
104
4.23 Relationship between holding temperature and microbial load in food
Table 4.33 shows the correlation analysis between holding temperature and microbial loads in
foods for each organism. The analysis shows that microbial load of E coli in food had
significantly fair but inverse relationship with the holding temperature (p<0.05). However, there
was no significant relationship between food holding temperature and microbial count of B
cereus, Staph. aureus and fecal coliform in the selected foods studied.
105
Table 4.23 Food holding temperature and microbial loads in food
Organism Correlation coefficient p-value
B. aeurus -0.340 0.131
Staph. aureus -0.085 0.729
E-coli -0.519* 0.016
Fecal Coliform -0.202 0.380
*Correlation is significant at p<0.05
106
4.24 Findings from In-depth Interviews with School Nurses and Head of Food
Departments
All interviewees acknowledged the possibility of food hazard occurring in the schools. Many of
the respondents reported not having food safety training manual. However, the schools follow
food safety management measure and control stipulated by the school management board.
Furthermore, majority of the respondents claimed that they do regular random monitoring and
checks to ensure that food handlers comply with basic food safety principles.
Interviewees claimed that there were written and documented policy and procedures for visitors
(vendors, teachers, students, etc) to the kitchen and dining areas. However, they equally admitted
that these procedures may not have been followed by food handlers at all times
Some of the interviewee claimed that there was a documented orientation program on food safety
for new employees; however, the interviewer was not shown any of these documents. Majority
of the interviewee said that there was no documented orientation program on food safety nor was
there an on-going training program on food safety. A statement of one of the respondents goes
thus: “We expect any food handler we employed to have known the basics of food preparation
and cooking.”
All interviewees reported that pre-employment medical certification was a requirement to work
as cook and food servers in the schools. They were however not strict as to the certification by
medical personnel as long as the applicant is experienced to do the job and looks physically fit.
Most of the respondent did not have records of pre- employment medical certification of the food
handlers. They said, “It is the responsibilities of the various hospitals that these medical tests
were carried out to keep such records”. According to the respondents, on the job routine medical
examination was however almost nonexistent.
Most of the respondents reported that there is no minimum training or education an employee
must acquire to work as food handler. According to some of the respondents, “Cooks are
employed based on their experience in cooking, and not training or education on cooking”
107
Most interviewees reported cough, malaria, headache, abdominal upset and general fatigue as the
common illness reported amongst the food handlers. According to one the respondents,
“Malaria, abdominal pain, diarrhea, cough and headache are illnesses frequently reported by
boarding students and boarding staff”
A majority of the respondents reported that cases of food borne diseases are rare; they however
admitted that two or more students do occasionally come down with certain illnesses like
diarrhea, vomiting, abdominal pain, fever etc., but they believed these are just isolated cases. In
such instances, students are taken to the nearest government hospital for treatment. In the words
of one of the respondents, “This illness is just as a result of the student overeating and not a food
related illness”. Only one respondent acknowledged remembering a previous food related illness
of a group of students after consuming bean soup called “gbegiri” but the interviewer was not
privileged to see the documentation of how this particular incidence was handled.
The interviewees claimed that their schools have control measures in place to prevent possible
food related diseases. They said that food handlers always wash their hands before cooking and
that the food handlers are enforced to wear neat apron, cover their heads, maintain trimmed nails
and ensure good personal hygiene.
108
CHAPTER FIVE
DISCUSSION
This chapter considers the results of the questionnaire survey used to obtain information on the
knowledge, attitude and practices, socio- demographic characteristics, food safety education and
hygiene practices of food handlers. The chapter also presents the implications of results obtained
for mean holding temperatures, food holding time, microbiological quality of water used for food
preparation, drinking, and microbiological quality of food samples collected in the five selected
boarding schools in Ibadan. Information on the sanitary condition of the dining hall, kitchen,
toilet and hygiene practices of food handlers in the five selected boarding schools were also
highlighted.
Ekwenye et al 2005 earlier observed food safety knowledge was significantly higher among food
handlers with higher educational level and among younger staff and those attending continuing
educational course about food hygiene while very few food handlers had participated in formal
training in food hygiene.
109
5.2 Microbiological Quality of Food Samples
According to the FDA and WHO, the maximum permissible limits of fecal coliform, staph
aureus and Bacillus cereus in cooked ready to eat food are ≥10, ≥ 102 and ≥104 cfu/g
respectively. However, E.coli should be absent in cooked food (WHO, 1994).The
microbiological analysis of food samples revealed that the bacterial isolate from all food
samples collected in the five boarding schools were B. cereus, S. aureus, E.coli, and Coliform.
This finding is similar to previous reports by Nichols et al. (1999) and Mensah et al. (2002) in
which B. cereus and E. coli were the prevalent bacteria isolates isolated from food in their
respective studies.
Although, the cooking temperatures of foods examined in this study reached levels capable of
destroying many vegetative forms of food borne pathogens, the quantity of organisms ranging
from 2.0×108 to 1.8×109cfu/g either survived in the foods after cooking or were introduced
externally after cooking This may represent the group of heat resistant spore former and/or post
process contaminants (Inabo et al., 2000; Ehiri et al., 2001). The food contamination could also
have come from improper personal hygiene of cooks or dirty cooking utensils (Vivek et al.,
1995) The B.cereus count of 2.0×108 to 1.8×109 cfu/g recorded for cooked foods from all the
schools could have been initially introduced from the raw foods and food ingredients or due to
large number of vegetative cells that contaminated food ingredients (Obuekwe and Ogbimi,
1989). The isolation of B. cereus from all the cooked food samples in SLGS is of concern. This
may be explained by the ubiquitous distribution of this organism and its ability to form
endospores (Mckillip, 2000) or probably due to the unhygienic practices of the food handlers.
The result shows that the yam porridge prepared at GCI had higher B. cereus count than other
schools however; B cereus was not detected in yam porridge prepared in ISI neither was it
detected in the rice, moin moin and vegetable soup prepared at GCI. This high level of B cereus
contamination in yam porridge at GCI could be attributed to initial contamination of food
ingredients used in this particular school or post process contamination after the yam porridge
preparation
110
The result also reveals that the vegetable soup prepared at QSI had the highest count of B.
cereus, Staph aureus, E.coli and fecal coliform than vegetable soup prepared in other schools.
This result may however suggest the possibility of microbial exposure at the school either from
the ingredients used in food preparation or from food handling practices, since the highest level
of microbial exposure for the aforementioned food was observed at QSI than from other schools.
Microbial contamination of cooked rice was the lowest in all the schools compared to bacterial
contamination of other foods. Also, F. coliform had the highest microbial count in rice while
Staph aureus was not detected in all the rice prepared in the five schools. The fecal coliform
count of Akamu in CSS was similar to that of QSI and GSI but was higher than that in SLGS.
Coliform was detected in all the food samples tested for QSI but none was seen in all food
samples tested for the ISI. The presence of coliform in the food may have been from improperly
cleaned utensils, poor hygiene of food handlers, and the animals within the vicinity (along with
their fecal droppings) present in the food preparation environment (Ehiri et al., 2001)
The food safety problem associated with foods prepared among the studied schools were the
inadequate time and temperature exposure of akamu, extensive handling of foods by cooks after
preparation and the practice of leaving cooked foods uncovered till served to students. The
limited time/temperature exposure of 5 - 10 min during Akamu preparation was insufficient to
destroy B. cereus spores. This result is similar to that obtained by Oranusi et al, 2007 in the food
safety condition in boarding schools at Zaria.
Furthermore, it was also shown that the B. cereus isolated from rice in SLGS and CSS; the E.
coli found in rice at CSS; and fecal coliform isolated in the rice from CSS and GCI could be
traced to post process contamination. This is because rice prepared in majority of the schools was
devoid of the microorganisms. This result is similar to Tambekar et al (2006) which indicated a
high incidence of E.coli in ready to eat food which might have occurred through contamination
of cooked food by food handlers due to poor post cooking handling and contaminated cooking
utensils. The International Commission on Microbiological Specification for Food suggested the
acceptable limit of ≥ 104 for B. cereus in food. Based on this, the results obtained from this study
indicated that most of the ready-to-eat food samples examined did not meet bacteriological
quality standards.
111
5.3 Microbial quality of water used in food preparation
According to the WHO (1997) standards, the Total coliform, Fecal coliform and E. coli should
be absent from drinking water. The results of analysis for microbial quality of water used in the
selected schools shows that the fecal coliform and coliform levels were higher than the
permissible level in drinking water samples in all the schools. However, E coli were not detected
in the drinking water samples of ISI, CSS, and SLGS. Fecal coliform, coliform and E. coli were
all detected in the water used for washing. The high level of coliform contaminants in water may
be attributed to the hygiene practices of food handlers and the environmental sanitation in place.
The handling of water container can also contribute to the coliform contamination of water.
Handlers were seen using the same container for cooking and fetching water while water fetchers
were being dropped carelessly on the floor with no safety precautions. This result is similar to
that obtained by Adesiyan et al,( 1983) and Bryan et al.(1988) of which both reported that the
coliform contamination of well water might have occurred due to the use of unclean water
vessels.
Water for washing collected in SLGSI and CSS; contained E.coli levels higher than the
permissible limits. However, E. coli was absent from drinking and cooking water. The presence
of coliform may be attributed to contamination introduced during washing since the same water
for washing might have been reused several times before being discarded. Also, the high
coliform in water from QSI may be attributed to improper handling procedure as water was
fetched in an unhygienic way from the borehole and Well, and then transported in an open
container with no safety precautions. This is similar to the inference made by Alabi and
Adesiyan (1985) and Ehiri et al. (2001). This suggests that the contamination of well and tap
water by fecal organisms could be from water storage vessels and from persons collecting the
water.
Bacteriological quality of drinking, cooking and washing water samples collected from QSI and
GCI revealed that all water samples had bacteria load higher than the permissible limits. Overall,
it was shown that cooking water was highly contaminated with coliform while drinking water
was also polluted. Therefore, this water was not fit for consumption.
112
5.4 Mean temperature of food
The temperature danger zone is the temperature range in which microorganisms grow quickly
and sometimes reach levels that can make people ill. The temperature between 5°C–57°C was
identified as the temperature danger zone(FDA, 2009)
Findings from the results of temperature measurement of food at holding indicates that the
majority of schools held food at temperature above 57°C which is the recommended temperature
for hot ready to eat food. The mean temperature of individual food is within the recommended
standard except for Akamu. International School of University of Ibadan had the highest mean
holding food temperature for hot ready to eat food. The result shows that there was a significant
difference in the holding temperature among schools and that there was a significant difference
in holding temperature in all schools in comparison with the United States Food and Drug
Administration (USFDA) standards.
Most food prepared in the five selected Public Secondary Schools with Boarding Facilities
reached boiling point at cooking but the limited time/temperature exposure during cooking for
some foods like akamu and moin moin can be a determining factor in the overall safety of the
consumed food.
Findings of this study revealed that about 65% of the boarding schools use firewood methods of
cooking. This method of cooking results in the creation of carbon monoxide particulate and
smog pollution. These can cause a variety of symptoms ranging from headaches and nausea, to
potentially life-threatening conditions including cardiovascular and respiratory diseases to the
food handlers (Yang, 2011). This method is a major source of potentially climate changes soot in
the air. Less than 35% of the schools use bottled gas which is a cleaner and more efficient
method of cooking. Thus the US medical studies on health risk have found little to no substantial
health and environmental implication beyond the dangers of gas leaks and possible gas explosion
during cooking (Westlake, 2009).
113
5.6 Food handling practices
Findings from observations indicate that some of the schools prepared food overnight and then
store it in the refrigerator or cooler for subsequent use. This practice may be responsible for the
microbial proliferation which occurs when the bulk rice was stored overnight. This was the
common practice at SLGS. For example, rice was usually reheated in the morning many hours
later after being cooked. The result is consistent with the study by Mejayi, 2009 on the
microbiological quality of ready to eat food sold in secondary school in Abeokuta Ogun State.
The study inferred that the occurrence of microbial growth in ready to eat food was as a result of
the food handling practices of the food handlers.
Although, cooks were able to maintain temperature high enough to reach the cooking state for
moin moin, this temperature may not be maintained long enough to kill all microorganisms
present during cooking for the fear of moi moi getting burnt. The moi moi prepared in majority of
the schools were well steamed and held at average temperature of 57of °C and above, in order to
prevent multiplication of microbes. Mean holding temperature of 57°C and mean holding time of
less than 1 hour was recorded and this food temperature/time condition was adequate to prevent
and maintain any possible exposure to microorganisms. However, the results revealed that the
microbial contamination of most food samples was still very high. Thus the method of storage
during holding is a possible source of bacteria to the foods. The result showed that food from
QSI showed a considerable growth of B cereus, E.coli and fecal coliform in moi moi. This may
be because moi moin at Queen School was usually dished in large uncovered cooler and the
students were expected to equally dish into their individual plates. This multiple handling and
transfer process in food handling can encourage considerable level of bacterial contamination.
This was consistent with the findings of previous studies on food safety conducted in boarding
secondary schools in Zaria (Oranusi et al, 2007).
Another major food safety problem associated with food handling practices in the schools was
the inadequate time/temperature exposure of Akamu. Ordinarily, decanting of water in the
akamu reduces pH which in turn reduces microbial growth. Also,, increasing the
time/temperature during cooking should be enough to kill microorganisms. However, the limited
time/temperature exposure during the preparation of Akamu at QSI may be insufficient to
destroy B. cereus spores. The Akamu was not exposed to high temperature to prevent food from
114
getting burnt and this may possibly explain why there was considerable bacteria growth seen in
the Akamu. The result shows that yam porridge prepared at QSI had higher mean colony count
of B. cereus than other schools. This could be as a result of contamination by food condiments
and other seasoning such as grounded crayfish and pepper that were added to yam at later stage
of food preparation. Thus the limited time –temperature exposure may be a factor since there was
not enough heat to kill the existing bacteria in the added condiments
The results of this investigation indicate that food handlers in the five selected boarding schools
in Ibadan have an average knowledge of food safety. However, the result from the observation
checklist shows that food handlers may not always put this knowledge into practice. This result
is similar to findings on food handlers‟ knowledge and practice on food safety by Oteri and
Ekanem, 1989. Less than 6% of the food handlers had good attitude on food safety storage while
about a quarter of the food handlers will need improvement in knowledge on food safety storage.
More than 65% of the food handlers need improvement on knowledge, attitude and practice on
food temperature while more than a quarter of the food handlers need to improve their
knowledge attitude and practices on hand wash before, during and after food preparation. The
finding from this study indicates that about 73% of food handlers have good knowledge of hand
washing. However, very few of the few handlers at the boarding schools do practice effective
hand washing .This is consistent with the research by Manning (1994) that have earlier shown
that 81% of food handlers are aware of the importance of hand wash, but only 2% actually
practice thorough hand wash. Furthermore, in this survey, only 34% of the respondents managed
to prove that they know the right temperature for storage of hot and cold ready to eat foods. This
result is supported by Bas et al. (2004) who reported that knowledge of critical temperature of
food safety were low amongst studied food handlers. Walker et al. (2003) also reported that less
than half of 444 respondents‟ food handlers knew the correct temperature at which hot ready to
eat foods should be held.
Although there was no significant difference between food safety practice and marital status,
gender, age and level of education of food handlers studied. From the statistical analysis, It was
115
found that there was a significant relationship between food safety knowledge and practice of
food storage and between attitude and practice of food storage (p<0.05). This result was similar
to that of Wilcock et al,2004, who found that there was an association between knowledge and
current practice of food handlers and that the awareness of food handlers improved their
practice.
116
5.8.2 Toilet Facility
All the schools except GCI had toilet that was functional. Although there was a designated toilet
at GCI, the toilet had been converted to storage hence food handlers defecate in the nearby bush
and use paper or leave for sanitary cleaning. Most toilets in the schools used by the food handlers
were littered with dirt, water logged, had no running piped water and no hand washing fluid or
soap for sanitary cleaning. A key step in promoting good hygiene is ensuring that there are hand
washing stations and toilet facilities available in close proximity (not more than ¼ mile) to the
food handlers‟ station. Mishandling and disregard of hygienic measures on the part of the food
handlers using unsanitary toilet may enable pathogenic bacteria to come into contact with food
and in some cases survive and multiply in sufficient numbers to cause illness in the
consumer(Malugeta et al, 2012)
Good personal hygiene is a major quality expected from food handlers. The inadequate personal
hygiene observed in food handlers with respect to wearing of clean protective apron, head
covering, hand washing, coughing without mouth covering, sneezing at the food area, keeping of
long nails, wearing conspicuous ring and ornaments are sources of concern. Food safety can be
promoted by educating the food handlers about personal hygiene; therefore, the knowledge of
food hygiene must be imparted on the food handlers in order to understand the need to
effectively maintain good personal hygiene (Bas et al, 2004).
117
CHAPTER SIX
6.1 Conclusions
This study set out to evaluate food safety and hygiene conditions in boarding schools using
factors and conditions that may directly or indirectly affect safety of food consumed such as
food holding temperature; microbiological quality of food and water; sanitary conditions of the
kitchen, dining and toilets; knowledge, attitude and practices of food handlers.
Students in the boarding schools like any other group of people have the right to consume safe
and wholesome food. Hence effective school food control is very necessary to achieve this.
Therefore, ensuring good microbiological quality of food consumed at these schools is very
paramount. Findings from this study show that many of the food prepared in the schools are of
poor microbiological quality and can be described to be unfit for consumption. The same can be
said of the drinking and cooking water which were shown to contain an unacceptably high
coliform and sometimes polluted with E.coli.
The study also revealed that although, effective food holding temperature were attained for most
food in the boarding schools, mean holding temperature of food like Akamu was lower than the
minimum temperature 57°C for hot ready to eat food. The limited time –temperature exposure
had been implicated for this. The same can also be said of moi moi in which steam but not high
heat was required to cook at limited time. There was no significant relationship between food
holding temperature and microbial count in foods.
It was also discovered that all the boarding schools had toilets with poor hygiene conditions.
There was no running water for sanitary cleansing neither were there provisions for wash hand
soap to use after defecation. Government College and QSI have kitchen and dining with poor
hygiene conditions, CSS had kitchen with poor hygiene condition, while food handlers at GCI
could only defecate and urinate in the nearby bush since there was no functional toilet. In
general, poor environmental sanitation was discovered in majority of the schools studied. They
118
do not conform to the guidelines stipulated for school sanitation as contained in the Policy
Guidelines on School Sanitation developed by Federal Ministry of Environment.
The study also revealed that the food handlers at the boarding schools had barely average
knowledge on food safety. In general, the food handlers showed poor attitude on safe food
storage. Majority of the food handlers‟ exhibit poor food handling practices. Poor hand washing
with poor knowledge, attitude and practice on safe food temperature.
6.2 Recommendations
Based on the findings and observation during the course of the study, some of the
recommendations emphasize measures that could prevent food contamination and possible food
disease outbreak by promoting good hygiene that would ensure safety of food consumed in the
boarding schools. This includes but not limited to the following:
1. The activities of the food handlers in boarding schools should be regularly monitored
and appropriate corrections should be made by supervisors when food safety procedures
are breached
2. Strict hygiene control should be practiced at all time during preparation and dispensing of
food to prevent food contamination
3. Oyo State Ministry of Health through the School Health Board should establish a unit
that will register, train, educate and re-educate food handlers on food safety and hygiene
most importantly in the area of effective and safe food handling and environmental
sanitation
4. The Government should support and encourage more scientific research on food safety
by providing grants and other useful facilities that will motivate tertiary institutions and
relevant agencies in carrying out various researches on food safety.
5. Certain levels of food safety standards and specifications should be established by
relevant Government authorities that every boarding school must adhere to when setting
up the kitchen and dining hall to protect the students and staff from possible food borne
disease outbreak.
119
6. Environmental and health education programmes should be established to raise
awareness on food safety, the causes and prevention in every food processing centers.
This will ensure the food handlers are better equipped in the area of food hygiene and
environmental sanitation.
120
REFERENCES
Adesiyan, A.A., Adekeye, J.O., Umoh, J.U., Nadara, J (1983). Studies on well water and
possible health risks in Katsina, Nigeria. J Hygiene 90:199-204
Alabi, D.A., Adesiyan, A.A (1985). Studies on microbial quality of filtered water in households
of a university community in Nigeria. J Hygiene 96: 239-248.
Almanza, B.A., Nesmith, M (2003). Food handlers certification regulations in the United States.
Journal of Environmental Health 16: 45-72.
American School Food Service Association.(1999) Straight from the source: Findings from
ASFSA‟s 1999 operations survey. School Foodservice & Nutrition, 53, 16.
Bamford, T.W (1967). Rise of the public schools, a study of boys‟ public boarding schools in
England and Wales from 1837 to the present day.
Bas, M., Ersun, A.S and Kıvanc, G (2004). The evaluation of food hygiene and knowledge,
attitudes and practices of food handlers in food businesses in Turkey. Journal of Food
Control 17: 317-322.
Blakeslee, K.M., Penner, K.P (1999). A case study of a school foodservice cook-chill operation
Used to develop a Hazard Analysis Critical Control Point Program. J Dairy, Food and
Environmental Sanitation, 19, 257-267.
Breed R.S., Murray, E.G.D., and Smith, N.R (1957). Bergeys‟s Manual of Determinative
Bacteriology, 7th ed. Baltimore: The Williams and Wilkins Company.
Bruhn, C. M., Schutz, H. G (1999). Consumer food safety knowledge and practices. Journal
of Food Safety 19:73-87.
121
Bryan, F.L(1988). Risks of practices, procedures and processes that lead to out-breaks of
food borne diseases. Journal of Food Protection 1: 663-673.
.Burghardt, J.A., Gordon, A.R., Fraker, T.M (1995). Meals offered in the national school lunch
program and school breakfast program. Am J Clin Nutr. 61:187–198.
CDC (1999). Surveillance of food borne disease outbreaks, United States, MMWR surveill sum
45:1-66.
CDC (2000). Preliminary FoodNet data on the incidence of food illness: Selected sites, United
States. MMWR 51: 325-329.
Coombs, P.I., Prosser, R.C., and Ahmed, H (1973.). New paths to learning for rural children and
youth ICED, New York.
Daniels, N.A (2002). Food borne disease outbreaks in United States schools. Pediatr. Dis. J.
21(7): 623-628.
Davies,F.L., Wilkinson, G (1973). Germination of Spores of Bacillus cereus in Milk and Milk
Dialysates: Effect of Heat Treatment. Bacteriol Journal.62(3) 123-192.
Ehiri, J.E., Azubuike, M.C., Ubbaonu, EC., Ibe, K.M., Ogbonna, M.O (2001).Critical Control
Points of complementary food preparation and handling in Eastern Nigeria. Bull. WHO
79: 423-433.
Ekwenye, U.N., Okoro, L.A., Ojimelukwe, P.C., Akaeru, B. and Ogbonnu, P (2005).
Comparative evaluation of the bacterocin characteristics of lactic acid bacteria from
selected traditional fermented food. J food science and Tech. 5(1):1-5.
122
Etling, A (1993). What is non formal education? Journal of Agricultural Education, 72-76.
Falola, T (1984). The political Economy of pre-colonial state: Ibadan, 1830-1900. University of
Ile-Ife Press,Ile-Ife.
FAO (2002). Agricultural Statistics; Food and Agricultural Organisation of the United
Nations, Rome www.fao.org.
FDA, Center for Food Safety & Applied Nutrition (2000). Web page manual:
11http://vm.cfsan.fda.gov/- ~ebam/bam-toc.html
FDA (2004). Food borne pathogenic microorganisms and natural toxins handbook.
http://www.fda.gov/dmslfs-toc.htm.
FDA (2009). Food Code :Annex 4-Management of food safety practices-Achieving Active
Managerial Control of Foodborne Illness Risk Factors. FDA webpage.
Felsenfeld, O. (1965). Notes on food, beverages and fomites contaminated with vibrio cholera.
Bulletin of the World Health Organization, 33(5), 725-734.
Food Act (1983). Definition of food: Malaysian Legislation. Act, 381. The commissioner of Law
Revision Malaysia.
Flanigan, B. (2006). The food safety factor. Am. School Board J. 193(6): 1-5.
Fry, A.M et al.(2005). Food borne disease. In GL. Principle and Practice of Infectious Disease,
6th ed, vol.1,pp 1286-130. Philadelphia Elsevier Churchill Livinggstone.
GAO (2002). Continued vigilance needed to ensure safety of school meals. United States Gov
Acc Office Pp 5-16.
Giampaoli, J., Cluskey, M., and Sneed, J. (2002). Developing a practical audit tool for assessing
employee food-handling practices. The Journal of Child Nutrition & Management.
123
Giampaoli, J., Sneed, J., Cluskey, M., and Koenig, H.F. (2002). School foodservice directors‟
attitudes and perceived challenges to implementing food safety and HACCP programs.
The Journal of Child Nutrition & Management.
Gilmore, S.A., and Dana, J.T. (1998). Food quality model for school food services.
The Journal of Child Nutrition & Management, 22, 32-30
http://www.univ.edu/centers/cdclv/ega/documents/eg burgess.pdf.
Highton, P.J., Hobbs, D.G(1972). Penicillin and cellwall synthesis: a study of Bacillus cereus
using electron microscopy. J Bacteriol.
Hobbs, B.C., Kendall, M., Gilbert, R.J(1968). Use of phenolphthale in diphosphate agar with
polymyxin as a selective medium for the isolation and enumeration of coagulase-
positive staphylococci from foods. Appl Microbiol. 16(3): 535.
Holmberg, S.D., Harris, J.R., Kay, D.E et al (1984). Foodborne transmission of cholera in
Micronesian households Lancet, i: 325-328.
Howes, M., McEwen, S., Griffith, M. and Harris, L (1996). Food handler certification by home
study: measuring changes in knowledge and behavior. Dairy Food Environmental
Sanitation 3:208-214.
Inabo, H.I., Ogbadu, L.J., Umoh, V.J., Ameh., J.B. (2000).Microbiological quality of selected
marketed condiments. Namoda Techscope J. 4: 20-30.
124
Kim,H.U., Goepfert, J.M (1971).Enumeration and Identification of Bacillus cereus in food:l.24
Hour Presumptive Test Medium. Appl. Microbiol.1971,22(4):581.
Kleis,J., Lang,L., Mietus, J.R. and Tiapula, F.T.S.(1973). Towards a contextual definition of
non-formal education. Nonformal education discussion papers, East Lansing, MI
Michigan State University,pp.3-6.
Larkin,J.M, Stokes, J.L (1966). Isolation of psychrophilic species of Bacillus. J Bacteriol. 91(5)
1667-167.
MacDougal, C., Powell, J.P., Johnson, C.K., Edmund, M.B., Polk, R.E (2005). Hospital and
community flouroquinolones use and resistant in staphylococcus aureus and E.coli in
17 US hospitals. Clin Infect Dis 41(4) 435-440, 2.
Manning, C.K (1994). Food safety knowledge and attitudes of workers from institutional and
temporary food service operations. Am Diet Assoc 1994; 94:895–97.
Martin, D.L., Gustafson, T.L., Pelosi J.W., Suarez, L., Pierce, G.V (1986). Contaminated food
produce: a common source for two outbreaks of Shigella gastroenteritis. Am J
Epidemiol 1986; 124:299–305.
125
Mazengia, M.S., Chidavaenzi, M., Bradley, M. et al(2002). Effective and culturally acceptable
water storage in Zimbabwe: maintaining the quality of water abstracted from upgraded
family wells. Journal of Environmental Health 64, 15-18.
McCabe-Sellers, B.J., Beattie, S.E (2004). Food safety: Emerging trends in food borne illness
surveillance and prevention. J. Am. Diet. Association.104: 1708-1717.
McKillip, J. L. (2000). Prevalence and expression of enterotoxins in Bacillus cereus and other
Mensah, P., Manu, D.Y., Darko, K.O., Ablor- dey, A (2002). Street foods in Accra, Ghana: how
safe are they?. Bull WHO 2002; 80: 546-54.
Mulugeta, K., Bayeh, A.(2012). The sanitary conditions of food service establishments and food
safety knowledge and practices of food handlers in Bahir dar town.. Ethiop J Health
Sci. Vol. 22, No.1 pp 28-32.
Mortlock et al (1999). A national survey of food hygiene training and qualification levels in the
UK food industry. International Journal of Environmental Health Research 10: 2 p
111- 123.
126
Musa, O.I., Akande, T.M (2003). Food hygiene practices of food vendors in secondary schools
in Ilorin. Niger Postgrad Med J. 2003 Sep; 10(3):192-6.
Nataro, J.P., Steiner, T., Guerrant, L.R (1998) Enteroaggregative E. coli. Emerging Infect. Dis.
3: 459-465.
Neill, C (1980). Safe-n-sensible food safety. School Food Service Journal, 34(7). 44-46.
Nicholas, A.D. et al (1999). Foodborne disease outbreaks in United States schools. Pediatr Infect
Dis J, Vol. 21, No. 7:623–628.
Nigeria Tribune (1994). Medical students ends up in hospital after consuming salad. April
12;Pp 7
Noah, N (2009) Food poisoning from raw fruit and vegetables. Introduction Epidemiol.
Infect.Mar 2009; 137(3): 305-6.
Obuekwe, C.D., Ogbimi, A.O (1989). Prevalence of Bacillus cereus and other Gram- positive
bacteria in Nigerian dried food condiments. Nig Food J. 7: 11-19.
Oladimeji, B.A and Fabiyi, A.K (1993). Increasing the Awareness of Safety Measures among
Secondary School Pupils: The Ile-Ife Experience. Nigerian School Health Journal
8.2:9-19.
Omemu, A M., Aderoju, S.T (2007) Food safety knowledge and practices of street food vendors
in the city of Abeokuta, Nigeria
Omotayo, R.K and Denloye, S.A. (2002) The Nigerian experience on food safety regulations
FAO/WHO global forum on food safety regulators Marrakesh Morocco.
127
Oni, V., Oni,A., Esumeh, F. (2010) Prevalence of Bacteria food poison from vegetable salads.
Journal of Nutrition and Wellness, Vol.10 (2).
Oranusi, S., Galadima, M., Umoh, V. J., Nwanze, P. I (2007). Food safety evaluation in boarding
schools in Zaria Nigeria ,using the HACCP system; Academic Journals of Scientific
Research and Essay, Vol .2(10), pp. 426-433.
Oteri, T., Ekanem, E.E (1989). Food hygiene behavior among hospital food handlers.
J. Public health; 103(3), 153-159.
Pesigan, T.P., Plantilla, J., Rolda, M (1967). Applied studies on the viability of El Tor vibrios
and cereus Bull World Health Organ ;37(5); 779-786.
Quiroz, E.S., Bern, C., MacArthur, J.R (2000). An outbreak of cryptosporidiosis linked to a
food handler. J Infect Dis ; 181:695–700.
Rimal, A., Fletcher, S. M., McWatters,K.H., Misra, S.K., and Deodhar, S. (2001). Perception of
food safety and changes in food consumption habit: a consumer analysis. International
J of Consumer Studies 25(1), 43-52.
Roseman, M., Kurzynske, J. (2006). Food safety perceptions and behaviors of Kentucky food
handlers. Journal of Food Protection 69:1412-1421.
128
Sneed, J., Strohbehn, C., Gilmore, S.A, and Mendonca, A. (2006). Microbiological Evaluation of
Food service contact surface in Iowa assisted-living facilities. Journal of American
Dietitians Associations 104:1722-1724.
SON.(2007). Nigerian Standard for Drinking Water Quality. Nigerian Industrial Standard.
Pp 8- 9.
Sudershan, R .V., Pratima, R., Kalpagam, P (2009). Food safety research in India: a
review, As. J. Food Ag-Ind. 2(03), 412-433.
Sukyung, Y., Sneed, J(2003). Implementation of HACCP and Prerequisite programs in school
foodservice. J. Amer. Diet. Assn. Vol. 103. No. 1,pp.55-60.
Tambekar, D.H., Hirulkar,N.B., KaLikar, M.V., Patil, YS., Gulhane, S.R.(2006). Prevalence of
thermotolerant E. coli in drinking water and its multidrug resistance . Res.J. Microbiol.,
1:458-462.
Tan,S.L., Cheng, P.L., Soon,H.K., Ghazali,H. and Mahyudin, N.A(2012). A qualitative study on
personal hygiene knowledge and practices among food handlers at selected primary
schools in Klangvalley area,Selangor, Malaysia. Int.food Research J.20(1):71-76.
Tanwir, F., saboor,A., Shan, M.H(2003). Water contamination, health hazards and public
awareness: A case of the urban Punjab Pakistan. Int.J.Agric.Biol., 5: 460-462.
Thidarat, C., Suwat., S, Duangjai, M(2011) Food Safety Knowledge, Attitude and Practice of
Food Handlers and Microbiological and Chemical Food Quality Assessment of Food
for Monks in Ratchathewi District, Bangkok Asia Journal of Public
Health 2:1-8.
129
Udoh, C.O (1996). The College that is Health Education. An Inaugural Lecture. University of
Ibadan.
Umoh, V. J., Odoba, M.B.(1999). Safety and quality evaluation of street foods sold in Zaria
Nigeria Food Control 1999; 10:9-10. 30.
UNFPA(1998). The State of World Population: The New Generations. United Nation Population
Fund, New York.
Vanguard Nigeria (2008). Thirty agrochemical products banned in Nigeria after deaths. May 19;
Pp 12.
Vivek, k., William, M.S., Rebecca S.J., Thomas, S.J., James, M.M(1995). Molecular population
genetic analysis of S. aureus recovered from cows. J.Clin. Microbiol. 33:376-380.
Walker, E., Pritchard, C., and Forsythe, S.(2003). Food handlers‟ hygiene knowledge in small
food businesses. Food Control, 14(5), 339-343.
WHO (1953). Third European Seminar for Sanitary Engineers on design and operations of septic
tanks. Geneva. WHO monograph series no 18.
WHO (1997). Guideline for Drinking Water Quality 2nd edition. Geneva.
WHO(1999). Improving Health through schools: National and International strategies. Geneva
130
WHO (2002). Food safety and food borne illness. Geneva.
WHO (2003). Creating an Environment for Emotional and Social Well-Being. An important
responsibility of a Health-Promoting and Child Friendly School Education.
WHO (2006). Five keys to safe food manual. Department of food safety, zoonoses and food
borne diseases. Geneva.
WHO (2009). Integrating Poverty and Gender into Health Programmes, a source book for health
professionals. Module on water sanitation and food. Geneva.
Wilcock, A., Pun, M., Khanona, J., Aung, M. (2004). Consumer attitudes , knowledge and
behavior: a review of food safety issues Trends. Food Sci & Technol; 15: 56-66.
Wogu, M. D., Omoruyi, M. I., Odeh, H. O. and Guobadia, J. N. (2011) Microbial load in ready-
to-eat rice sold in Benin City. Journal of Microbiology and Antimicrobials Vol. 3(2),
Pp. 29-33.
Yang, S (2011). Wood smoke from cooking fires linked to pneumonia, cognitive impacts. UC
Berkely News Centre.
131
APPENDIX 1
PICTURE GALLERY
Food handler uses same container for food preparation and washing
Food handler dishes food unhygenically with bare hand into open food containers
132
Food is hygienically served in covered food containers
133
Kitchen also serves as storage place for firewood and unused cooking materials
134
APPENDIX 2
QUESTIONNAIRE
Dear sir/ma
It is not compulsory to take part in this study. You may decide not to be involved. If you wish,
you may also withdraw from the research at anytime. If you decide to participate, we will like to
inform you that whatever information you give to us will be kept secret. It will not be revealed to
persons, schools, principal or the school authorities.
I understand all that has been explained above and I am willing to participate in the study
(c) Not willing to sign or thumbprint but willing to participate in the study
Kindly state the reason for not willing to sign or thumbprint before participating when
applicable…………………………………………………………………...........................
...............................................................................................................................................
………………………………………………………………………………………………
135
NOTE: DO NOT WRITE YOUR NAME OR THE NAME OF YOUR SCHOOL ON THIS
QUESTIONNAIRE
Instructions
Answer truthfully
SECTION A
SOCIO-DEMOGRAPHIC INFORMATION
1. Serial number
2. Age (in years)
3. Sex (a) Male ( ) (b) Female( )
4. Marital status (a) Single( ) (b) Married( ) (c)Separated( ) (d) Divorced( )
5. Religion (a) Christianity ( ) (b) Islamic ( ) (c) Traditional ( )
(d) Others…………
6. Occupation (a) Cook ( ) (b) Cooking Staff ( ) (c) Others……………………
7. Level of Education (a) No formal Education ( ) (b) Primary ( ) (c) Secondary ( )
(d) Tertiary ( )
8. Length of time on the job as food handler …………………?
SECTION B
136
4. Has the school you work incorporated HACCP in the food service system?
(a) Yes ( ) (b) No ( )
SECTION C
ENVIRONMENT AND FOOD SAFETY
1. What type of domestic water source(s) do you have in the school? You may pick more
than one source. (a) Spring ( ) (b) Stream ( ) (c) Well ( ) (d) Borehole ( ) (e) Tap ( )
(f) Pond ( ) (g) Others please specify………………….
2. How long will it take you to walk from where you fetch water to the food preparation
areas? (a) Less than 3mins ( ) (b) Greater than 3mins ( ) (c) Greater than 5mins( )
3. What method(s) of sewage disposal do you have in the school? You may pick more than
one source (a) Pit latrine ( ) (b) Septic tank( ) (c) Pour flush( ) (d) Aqua privy( )
(e) Throw into bush( )
4. What is the walking distance between the sewage disposal point(s) and the food
preparation areas? (a) Less than 2mins ( ) (b) Less than 5mins ( ) (c) greater than
5mins ( ) (d) Greater than 10mins( )
5. Do you have domestic animal(s) around the food preparation area?
(a) Yes ( ) (b) No ( )
6. If yes to Number 5, what type of domestic animal(s) do you have? Please
specify…………………………………………..…………………………………………
….………………………………………………
137
7. What method(s) of refuse disposal does your school have? (a) Dumping in open field ( )
(b) Sanitary lands fill ( ) (c) Dumping in a pit ( ) (d)Others, please
specify………………. (You may pick more than one choice)
8. What is the walking distance between the refuse disposal point(s) and the food
preparation area? (a) Less than 2mins ( ) (b) Less than 5mins ( ) (c) greater than
5mins ( ) (d) Greater than 10mins( )
9. Do you have procedures in place for pest control? (a) Yes ( ) (b) No ( )
10. If yes to Number 9, what types of pest control method(s) do you have? Please
specify………………….………………………………………………………….
11. Is the food preparation area/kitchen separate from the raw food storage place? (a) Yes ( )
(b) No ( )
12. Are there separate food preparation surfaces for raw and cooked food? (a) Yes ( )
(b) No ( )
13. What types(s) of cooking facilities do you use? You may pick more than one choice.
(a) Firewoods ( ) (b) kerosene stove ( ) (c) .Bottled gas ( ) (d) Other, please
specify………………
SECTION D
KNOWLEDE ATTITUDES AND PRACTICES OF FOOD HANDLERS
KNOWLEDGE
1. Below is a table with list of diseases. Indicate by ticking “True” or “False” for the
disease(s) that is (are) food borne in nature. If you are not sure, tick, don‟t know”.
S/N DISEASES True False Don’t know
1 Dysentery
2 HIV/AIDS
3 Hepatitis A
4 Tuberculosis
5 Diabetics
6 Typhoid fever
7 Hypertension
8 Cholera
138
9 Diarrhea
10 Malaria
11 Worm infestation
13 Obesity
2. State the common symptoms of food borne diseases that you could easily remember?
…………………… …………………………….. ……………………………..
……………………. ……………………………. ……………………………..
3. The table below contains a list of statements about food handling practices. Go through
the statement carefully and tick whether the statement is True or false. If you are not sure
you may tick “Don‟t know”
STATEMENTS ON FOOD HANDLING PRACTICES True False Don’t
know
139
10 Food handlers are potential source of contamination to
food
4. The table below contains list of diseases that must be reported by food handlers when
contracted. Tick to indicate “True” or “False”. If you are not sure, tick “Don‟t know”.
140
ATTITUDES
The table below shows list of statements that describe attitudes toward food hygiene and related
issues. Please indicate by ticking “Agree” or “Disagree”. You may tick “Uncertain” if you are
not sure on what the answer should be.
11 You should wipe your hands with your apron after hand
washing.
141
PRACTICEES
1. Do you wash your hand when handling food? (a) Yes ( ) (b) No ( )
2. If yes to question 1, answer the below questions ticking either “Always” “Sometimes” or
“Rarely”.
How would you describe your hand washing pattern at the following critical points?
S/N CRITICAL POINTS Sometimes Always Rarely
1 Before cooking starts
2 After cooking ends
3 Before touching unwrapped cooked food
4 After touching unwrapped cooked food
5 After sneezing or coughing
6 After handling the food ingredients
7 After leaving the kitchen area
8 When entering the kitchen
9 Before touching unwrapped raw food
10 After touching unwrapped raw food
11 After hand tasting the food
12 After using the toilet
3. Do you check the expiration date of food at the point of purchase? (a) Yes ( ) (b) No ( )
4. Below is a table showing the list of various methods of hand washing. Please tick
appropriately based on your practice of hand washing.
s/n Methods of hand washing Sometimes Always Rarely
1 Water
2 Water and soap
3 Disposable paper towel
4 Cloth towel or cloth
5 Hand drying
142
5. Raw and cooked food should be stored : (a) Together ( ) (b) Separate ( ) (c) No
particular form of storage ( )
6. Do you regularly check the temperature of the raw food stored? (a) Yes ( ) (b) No ( )
7. If yes to question 6, what instrument(s) do you use to check the food temperature?
…………………………
8. What temperatures do you store chilled foods? .............................................................
9. What temperature do you store cooked or reheated food? ……………………………..
10. Do you clean food preparation areas and surfaces after using them? (a) Yes ( ) (b) No ( )
11. If yes to question 10, at what point(s) do you clean the food preparation area and surface?
(a) Before cooking starts only ( ) (b) After cooking ends only ( ) (c) Before and after
cooking end ( )
12. Do you prepare food well in advance before serving? (a) Yes ( ) (b) No ( )
13. If yes to question 12, how long do you normally hold the food before serving? Please
specify in hours………………………………..
14. Do you prepare food well in advance (greater than 4hrs) before serving? (a) Yes ( )
(b) No ( )
15. Do you reheat your food before serving? (a) Yes ( ) (b) No ( )
16. Do you take some time off work if you are ill or having a particular type of sickness?
(a) Yes ( ) (b) No ( )
17. If yes to question 16, which sickness(s) did you contract that you took sometime off
work? Please specify………………………………………...........................................
18. Are pest control program in place for the kitchen and dinning area? (a) Yes ( ) (b) No ( )
19. If yes to question 18, what type(s) of pest control method do you use in your school?
Please specify…………………………………………………………………………..
20. Do you use personal protective devices when cooking or handling food? (a) Yes ( )
(b) No ( )
21. If yes to question 20, what type(s) of protective device(s) do you use? Please
specify……………………………………………………………………………………
143
APPENDIX 3
OBSERVATION CHECKLIST
Observation checklist for determining sanitary conditions of the kitchen, toilet dinning,
and hygiene state of the food handlers in the boarding schools
Name of School………………………………………
Type of School (single/mixed)
Name of community
Status of community (urban, semi-urban, rural)……….
LGA………………………
State………………………
Total Population……………………
144
13 Presence of visible smoke particles on the walls
20 Adequate ventilation
21 Adequate lightning
5 Toilet also stores warn out materials clothes and old items
145
Physical Observation of Dining
Item Description Yes No Remarks
1 Dining hall available
8 Adequate ventilation
146
APPENDIX 4
IN-DEPTH INTERVIEW GUIDE
FOOD SAFE TY AND HYGIENE CONDITIONS IN SELECTED PUBLICBOARDING
SECONDARY SCHOOLS IN IBADAN, NIGERIA
A. Introduction
I am Imam Muhammed Isiaku, a postgraduate student of Environmental Health in the
Faculty of Public Health, College of Medicine, and University of Ibadan.
I thank you for accepting to participate in this interview. The interview intends enquire about
the food safety and hygiene conditions in selected public boarding secondary schools
The outcome of this study will be helpful in further improving safety of food and hygiene
conditions in the boarding schools.
With your permission, I will like to use a tape recorder because there is a limit to what I can
remember and I do not want to forget the useful information you will provide
I assure you that what is discussed here will not be used in any way against anyone and all
that will be discussed will be kept strictly confidential
B. Questions
1. What are the food safety management procedures or guidelines currently in place in the
school?
2. What are procedures for cleaning and sanitizing food equipments and utensils in place
and are the food handlers following these procedures?
3. From your own observation, what are the common food related health problems e.g. food
poisoning, vomiting, diarrhea etc reported by the students and staff in the school?(Prove
for specific types of food related health problems and the severity)
4. In what ways did such food related health problems were managed? (Probe for specific
treatment measures and actions taken)
5. How these foods related health problems are documented and reported to the appropriate
health authorities?
6. What are the mechanisms put in place to prevent or reduce food related health problems?
7. What are the ways in which such mechanisms are supervised and monitored to ensure
compliance by the food handlers?
147
APPENDIX 5
INFORMED CONSENT FORM
You are free to take part in this research. You also have the right to withdraw at any given time if
you wish to. However, we will greatly appreciate your help in responding to the survey questions
by participating in the study
Consent: Now that the study has been explained to me and I fully understand the content of the
study process. I am willing to participate in the programme.
……………………… …………………………………
…………………………………………………………………………………………..
148
APPENDIX 6
IWE IFITONI LETI
Ko pon dan dan fun o lati kopa ninu eto iwadi yi. O si ni eto lati ma ko pa mo lasiko ti o wu o.
Sugbon inu mi yio dun ti o ba le kopa ni ibi eto iwadi yi
Ero mi: Nisinsinyi ti o ti salaye lori eto iwadi yi fun mi ti mo sigbo alaye re yekeyeke, emi yo
kopa ninu eto na.
…………………………………. ……………………………………
149