Awareness Regarding Healthy Eating Practices to Prevent Food Borne Disease among Somali Students Living in Bashundhara, Dhaka Bangladesh

Introduction

Food-borne diseases (FBD) are defined by the World Health Organization (WHO) as “diseases of infectious or toxic nature caused by agents that enter the body, or thought consumption of food or water” [1]. More than 250 FBDs have been described. In many countries, national health care organizations record FBD outbreaks, defined as the occurrence of two or more cases of a similar illness resulting from the ingestion of a common food [2]. The causes of food borne illness include viruses, bacteria, parasites, toxins, metals and prions, and bio toxins or pesticides occurs primarily through eating food and drinking water contaminated with pesticide residues, whereas substantial exposure can also occur in or around the home. Regarding the adverse effects on the environment (water, soil and air contamination from leaching, runoff, and spray drift, as well as the detrimental effects on wildlife, fish, plants, and other non-target organisms), many of these effects depend on the toxicity of the pesticide, the measures taken during its application, the dosage applied, the adsorption on soil colloids, the weather conditions prevailing after application, and how long the pesticide persists in the environment [3, 4, 5, 6].

The symptoms of foodborne illness range from mild gastroenteritis to life- threatening neurologic, hepatic and renal syndromes. True incidence of FBDs is difficult to evaluate, as many cases remain undeclared. WHO estimates that, worldwide food borne and water borne diarrheal diseases taken together kill about 2.2 million people annually and 1.9 million of them are children [7].

The global incidence of food borne disease is difficult to estimate, but it has been reported that in 2005 alone 1.8 million people died from diarrheal diseases. A great proportion of these cases can be attributed to contamination of food and drinking water. Additionally, diarrhea is a major cause of malnutrition in infants and young children [2, 7].

Factors contributing to foodborne illness include improper cleaning of raw foods, cross contamination with microbes such as E. Coli 0157:H7 (found in unpasteurized apple cider), salmonella (found in raw and undercooked eggs), Campylobacter (found in milk), inadequate heating, and improper cooling of foods [8, 9, 10].

The high prevalence of diarrheal diseases in many developing countries suggests major underlying food safety problems. In industrialized countries, the percentage of the population suffering from food borne diseases each year has been reported to be up to 30%. In the United States of America (USA), for example, around 76 million cases of food borne diseases, resulting in 325,000 hospitalizations and 5,000 deaths, are estimated to occur each year in Australia, there are an estimated 5.4 million cases of food borne illness every year, causing 18,000hospitalizations, 120death [2, 11].

In developing countries, a large segment of the population, including children, students, the urban poor, depend largely on street foods to meet their daily nutritional needs which are unhygienic, as it is cost- effective. During recent years, there has been an increasing food poisoning outbreaks resulting in serious health problems [3, 12]. In most countries (including the USA and France) bacteria are the leading cause of FBD and appear to be the causative agents of more than two thirds of the recorded FBD outbreaks. Staphylococcus aureus is one of the most common agents in bacterial food poisoning outbreaks. Staphylococci being ubiquitous, common inhabitants of human and animal skin, gain entry into the food products under poor hygienic and sanitary conditions. S. aureus is commonly found in the nose, throat, hair and skin of more than 50% of healthy individuals [10, 13]. Staphylococcal food intoxication is estimated to cause 185,000 cases of food borne illness annually [10, 14].

Moreover, majority of the developing countries have limited capacity to implement rules and regulations regarding food safety. Also, there is lack of effective surveillance and monitoring systems for foodborne illness, inspection systems for food safety, and educational programs regarding awareness of food hygiene [1, 15].

But there are ways to prevent harmful bacteria from contaminating your food and potentially making you sick, don’t leave foods that need to be chilled sitting out. refrigerate and freeze necessary foods right away, do use a meat thermometer to make sure your food is cooked thoroughly, do wash your hands for at least 20 seconds with warm, soapy water before and after handling any raw meats, fruits and vegetables, do wash utensils and disinfect surfaces before and after use ,don't defrost food on the kitchen counter instead use the refrigerator, cold running water, or the microwave oven, don't let food marinate at room temperature, keep marinating food refrigerated and don’t over pack the refrigerator [8, 13].

Methodology

A cross-sectional study will be conducted on a sample of 217 included both male and female Somali students living Bashundhara (Dhaka, Bangladesh), Structured questionnaire was used and face to face interview were carried out by the researcher himself, A convenience sampling technique was applied to select Respondents and Chi square was employed to examine the association between socio demographic characteristics and awareness regarding healthy eating practices to prevent food borne. The Target Population was Somali students living Bashundhara and sampled population will be 217 Somali students living Bashundhara, Dhaka Bangladesh. Bangladesh is a country in South Asia. It shares land borders with India and Myanmar. Bangladesh is the 92nd- largest sovereign state in the world, with an area of 147,570 square kilometers (56,980 sq. mi) and population 164.7 million. Dhaka is the capital city of Bangladesh, in southern Asia. Set beside the Buriganga River, it’s at the center of national government, trade and culture [16]. Bashundhara is a private residential area of Vatara Thana in Dhaka District in the Division of Dhaka, Bangladesh [17].

To assess Attitude towards healthy eating and hygiene practice;

Following questions were asked to the respondent Do you wash your hand before and after meal because of Washing your hands before you eat is an effective way to avoid becoming sick. Our hands spread and pick up illness-causing germs quite easily. They spread 80% of communicable diseases and after touching a hard surface, pick up 30-50% of the microorganisms on it [1].

To know how they stored foods by asking this question Where do you store raw or cooked food for use at house hold?

Because of Raw food and cooked food should be stored separately in the fridge. Bacteria from raw food can contaminate cold cooked food, and the bacteria can multiply to dangerous levels if the food is not cooked thoroughly again. I asked this question to the respondent to know where they mostly eat the food, where do you eat the food most of time. In developing countries, most of the population, including children, students, they depend largely on street foods to meet their daily nutritional needs which are unhygienic, as it is cost- effective. Resulting outbreak in serious health problems [8, 18].

Results

A total of 217 of Somali students were recruited in this cross sectional study design. Different independent variables have been measured to find-out outcome. Table 1 shows the frequency of socio-demographic variables of the study population. Study found 50.7% of respondents were in the age 18-24 years, while 46.1% Age group 25- 31 years and 32-38 years were 2.3%, 39 years and above were 0.92% .90.8% of respondents were male students and 9.2% were female students. Regarding their monthly income (monthly expenses), Most of students they get their monthly expenses between 16000-20000 Tk (63.6%) while 23.0% they get <16000 Tk and 13.4% of student they get >20000 Tk monthly. Regarding religion of Somali students 100% are Muslim. In their marital status most students 90.8% were single, 9.2% were married. According educational level of Somali students most of students 52.1% were graduate level while 47.9% were undergraduate level. According the number of Somali students living in every flat mostly 47.5% 4-6 person while 27.6% 6-10 person in a flat and 24.9% 2-4 person stay in a flat.

Table 2 Shows the distribution of Somali students respondents based on knowledge related variables. The 57.1% of students they know that food borne disease result from consumption of food containing pathogen, toxin chemicals while 23.5% they answer incorrectly about result of food borne disease and 19.4% of students they do not have knowledge about result of food borne disease. According illness feeling of Somali students while they are in Bangladesh 53.9% they feel food illness while they are in Bangladesh and 46.1% of Somali students they do not feel any illness related in food bore disease. 31.8% of Somali students who feel food borne disease they visit a doctor while 13.8% they use home remedies “rest, drink lots of water, etc.” and 8.8% of them they do not used no thing they become well after few days, (NOTE: 99 missing value because they do not feel any illness and they did not use any treatment). About 52.1% of Somali students they agree that the most common symptoms of food poisoning include upset of stomach, nausea, vomiting and diarrhea while 34.6% strongly agree, 9.2% of them they respond disagree and 4.1% they replay strongly disagree. Their knowledge about most common serious complication of food poisoning is dehydration mostly they respond yes 57.1% while 9.1% they respond no and 33.2% of them they respond we do not know the most common serious complication of food borne disease. Most 54.8% of student they get their knowledge related in food borne disease in internet while get health workers, 13.4% get in newspaper and 12.0% get their knowledge related in food borne disease their family members.

Table 3 Shows the attitude towards healthy eating and hygiene practice of Somali students 99.1% of respondents mentioned that they used to wash their hands before and after meal while 0.9% of them they don’t wash their hands before and after meal. Mostly 68.2% they store raw or cooked food for use at house hold in refrigerator while 22.1% left on the kitchen bench raw or cooked foods and 9.7% store raw or cooked foods in ideal temperature. According their utensils in a kitchen 53.0% they are properly manage utensils after food while 47.0% left their utensils scattered all over the kitchen for hours before being washed after food. Regarding properly cooked chicken and meat 92.2% they cooked well in chicken and meat while 7.8% they do not concentrate well cooked chicken and meat. Mostly 89.4% of Somali students they eat and cook food in home 9.7% they eat food in a restaurant and 0.9% they food in street foods.

Variables Total

$$ \begin{array}{l} 1 8 - 2 4 1 0 0 5 9 (5 9) 4 1 (4 1) \\ 2 5 - 3 1 1 1 0 6 1 (6 7. 8) 2 9 (3 2. 2) \\ 3 2 - 3 8 5 2 (4 0) 3 (6 0) \\ \end{array} $$

39 and above

2 2(100) 0(0)

What is your gender

Male 197 114(58) 83(42) P=0.438 Female 20 10(50) 10(50)

What is your monthly income

<16,000 Tk 50 24(48) 26(52) $$ \begin{array}{l} > 1 6, 0 0 0 \mathrm {T k} 3 0 2 7 (4 8) 2 8 (3 2) \\ 1 6, 0 0 0 - 2 0, 0 0 0 \mathrm {T k} 1 3 8 8 7 (6 3) 5 1 (3 7) \\ > 2 0 0 0 0 \mathrm {T k} 2 9 1 3 (4 5) 1 6 (5 5) \\ \end{array} $$

What is your religion Muslim 217 124(57) 93(43) “is a constant What is your marital status Single 197 113(57.4) 84(42.6) P=0.324 Married 20 11(55) 9(45) What is your educational level Graduate 113 70(62) 43(38) P=0.000 Undergraduate 104 54(52) 50(48) Number of members in your house hold 2-4 person 54 38(70) 16(30) food borne disease result from consumption of food containing P value pathogen, toxin or chemicals Good 51% Poor 49% What is your age Correct In correct No statistics are computed because what is your religion

Discussion

This cross-sectional study was designed with the justification regarding healthy eating practices to prevent food borne disease among Somali students living Bashundhara Dhaka Bangladesh. This study has used different types of variables; these are socio-demographic, and knowledge related factors. In this study 217 subjects were enrolled (197 male and 20 female) Somali students living in Bashundhara Dhaka Bangladesh. In this study Percentage of knowledge awareness of food borne disease was 51% ,a very similar study in Italy about knowledge of main food pathogen has found bit lower 48.7% knew the main foodborne pathogen [13]. Regarding the distribution of Somali student’s respondents based on knowledge related variables, the 43% of students they do not know that food borne disease result from consumption of food containing pathogen, toxin chemicals. Likewise, this is similar in Study conducted on Taif University students, Saudi Arabia which is to evaluate the knowledge, attitude and practice (KAP) on food poisoning of Results showed over 50% of the students lack the knowledge that raw eggs and raw white cheese have high risk for food poisoning. Also over 50% have negative attitude and they believe there is no risk from eating raw egg or drinking raw milk of she camel Sharif L, et al. [18] Previous study shows that knowledge was significantly (P<0.05) greater among those with a higher education level, in practice from a longer period of time, and who had attended education courses is one of correctly indicated and classified a common vehicles for food borne diseases [13]. However in this study it also reveals that There was also statistically association between educational level of respondents and knowledge of food borne illness (P=0.000). Number of members stay in a flat were found to be associated knowledge of food borne illness (P=0.006).

About half 52.1% of Somali students they agree that the most common symptoms of food poisoning include upset of stomach, nausea, vomiting and diarrhea. And their knowledge about most common serious complication of food poisoning is dehydration half of them 42.9% they do not know because they do not feel any food borne illness while they are in Bangladesh.

A study found that 99.1% of Somali student they wash their hands before and after meal and they have good personal hygiene, but 22.1% Left on raw or cooked food for use at house hold bench in the kitchen Despite continuing progress made in food quality and safety, several foodborne disease outbreaks, and the most frequently identified factors were cross-contamination, improper cooling, improper storage or holding foods at room temperature for long duration [8].

The participants showed a positive attitude, because vast majority (92.2%) ensure food is properly cooked before eating especially meat and chicken agreed that the correct application of routine food contamination control procedures provide adequate cooking for killing microorganisms. However, it should be pointed out that these findings were supported by food practices. Indeed, because food products consumed raw or without further cooking may become infected during harvesting and processing and that outbreak investigation indicate that food may also become contaminated by the unwashed hands of an infected food handler [13]. Thus, there is a need for public health educational interventions.

Conclusion

The findings of my Study revealed the student’s level of awareness about Regarding Healthy Eating Practices to Prevent Food Borne Disease among Somali Students Living In Bashundhara, Dhaka Bangladesh Was not good; most of the respondents have adequate knowledge food borne disease with significant predictor of level of knowledge related in food borne disease they get in internet usage But their attitude towards healthy eating and hygiene practice were poor such as they do not stored properly so they risk with or vulnerable food borne diseases and cross contamination of foods.

Similarly, more than half of the respondents left scattered household food utensils all over the kitchen for hours before being washed, it is very important to keep worktops and chopping boards clean because they touch the food you are going to eat. If they aren't properly clean, bacteria could spread to food and make you ill. And most of student they feel ill about food borne disease when they come Bangladesh because different food types they eat.

It also reveals that there was significant association age of respondents and knowledge of food borne illness. There was no significant association gender of respondents and knowledge of food borne illness. There was also statistically association between educational level of respondents and knowledge of food borne illness.

Numbers of members stay in a flat were found to be associated knowledge of food borne illness. Overall awareness of food borne disease and prevention was not good, thus there is a need for public health educational interventions.

Recommendations

Based on the findings of study the are to of: Awareness among Somali students should be strongly increased, through health promotion, health education and nutritional programs that encourage increase in consumption of fruits and vegetables which is recommended for a good health

• Most foodborne illnesses can be tracked to infected food handlers. Therefore, it is important that strict personal hygiene measures should be adopted during food preparation [8].
• The Somali students should also take precautions for prevention of foodborne illness. These include cooking food at appropriate temperatures and following standard hygiene practices, proper storage and prevention of cross-contamination of food, thus integrated intervention strategies are required to prevent foodborne illness at community level [15].
• Successful implementation of these interventions requires inter-sectorial collaboration including agriculture industry, food industry and health care sector [4, 6].
• The contamination of food is influenced by multiple factors and may occur anywhere along the food chain. Good agriculture practice and good manufacturing practice should be adopted to prevent introduction of pathogens into food products [20].