DETERMINANTS OF ORAL–FAECAL INFECTIONS AMONG FOOD HANDLERS IN NAIROBI COUNTY, KENYA. AN EVALUATION OF HYGIENE PRACTICES, TRAINING, AND WORKPLACE SANITATION

Abstract

Background: Foodborne diseases remain a major public health challenge in sub- Saharan Africa, where inadequate hygiene infrastructure and weak regulatory enforcement increase the risk of oral–fecal pathogen transmission. Food handlers play a critical role in either preventing or facilitating the spread of these infections, yet diagnostic data from Nairobi County are limited.
Objective: To determine the prevalence of intestinal pathogens among food handlers in Nairobi County using stool examination as an index test, and to assess associated hygiene practices and workplace conditions.
Results: Among 100 food handlers studied, 62% were female, 40% had attained secondary education, and 6% had no formal education. Gastrointestinal symptoms were reported by 51%, although only 53% held valid medical certificates. Stool analysis identified intestinal parasites in 33% (E. histolytica, 45.5%; G. lamblia, 33.2%), Salmonella spp. in 11%, and mixed infections in 7%. Asymptomatic carriage was observed in 20%. Hygiene practices were inadequate: only 28% had received food hygiene training, 28% used soap and water for hand washing, and 22% worked in establishments without access to clean drinking water. These findings indicate a high risk of infection, particularly in informal food establishments.
Conclusion: This study found that, despite good access to hygiene facilities, poor compliance with safe practices sustains infection risks, with glove use the only practice linked to reduced infections. Addressing both structural and behavioural gaps is crucial to lowering foodborne infection risks among Nairobi’s food handlers.

Recommendation: Improving food safety requires stronger regulation, routine screening, expanded training, consistent glove use, targeted behaviour change, integrated laboratory surveillance, and multi-sectoral collaboration to address both structural and behavioural gaps among food handlers.