BAHIR DAR UNIVERSITY

COLLAGE OF MEDICINE AND HEALTH SCINCE

Title;- ASSESSMENT OF KNOWLEDGE,ATTITUDE AND PRACTICE

OF FOOD HANDLERS ON FOOD HANDLING AND FOOD BORNE
DISEASE WORKING AT STUDENT CAFFTERIA IN BAHIR DAR
UNIVERSITY CAMPUSES, IN 2023 GC.

BY:-name(ID)

ADVISORS: - 1. Mr. Alamrew

A Research proposal to be Submitted to Comprehensive adult nursing

department, in Bahir dar university, in Partial Fulfillment of the
Requirements for the Degree of Bachelor of Sciences in Public Health

April, 2023
Bhir dar, Ethiopia

I
ABSTRACT
Background: While food is a basic human need it can sometimes cause a number
of illnesses arising from pathogenic and toxic substances, which find their way in
to food through contamination or spoilage. The term food borne disease is defined
as a disease usually infectious or toxic in nature caused by agents that enter the
body through ingestion of food. To achieve the public health goal of reducing food
borne diseases to the fullest extent possible, steps must be taken at each point in
the food chains where hazards can occur. The role of food handlers on this food
safety journey is a crucial one. Thus they should receive training on proper food
handling and practice the fundamental rules of food handling. Food handlers
should be kept under regular survelleince.
Objectives: The main objective of this study is to assessment of
knowledge,attitude and practice of food handlers on food handling and food borne
disease working at student cafteria in bahir dar university campuses, in 2023
toward food handling and food borne diseases.
Methods and materials: Descriptive cross sectional study will be conducted from
May 22-24, 2014.Sample of 192 food handlers currently working at students
cafeteria in Bahir dar University, All campuses will be included. Data will be
collected by face to face interview using a pre-tested structured questionnaire.
Data will be analyzed manually.
Descriptive statistics like frequency table, pie chart and chi-square test will be
used to characterize food handlers knowledge, attitude and practice on food
handling and food borne diseases. The results and discussions will be made after
the collected data are analyzed. Conclusion and recommendation will be drawn as
per the result.
Results: The result will be presented by table and figure.
Conclusion and recommendation: Based on the study findings conclusions will
be formatted and from conclusion appropriate recommendations will be forwarded
by principal Investigator.

II
ACKNOWLEDGEMENTS
I would like to give my heartfelt gratitude to our advisors Mr.Wuhib Zeine and
Mr.Kalkidan Hussein for their encouragement, necessary guidance and support
while the preparation of this proposal.
I would like to acknowledge Jimma university health science librarian for helping
me in searching important references.

III
Table of contents

Table of Contents
ABSTRACT.................................................................................................................................................I
Acronyms and Abbreviations.....................................................................................................................VI
CHAPTER ONE..........................................................................................................................................1
INTRODUCTION.......................................................................................................................................1
1.1 Background.......................................................................................................................................1
1.2 Statement of the problem...................................................................................................................2
1.3.Significance of the Study...................................................................................................................4
Chapter Two................................................................................................................................................5
2.1 Literature Review..............................................................................................................................5
Chapter Three..............................................................................................................................................8
Objectives....................................................................................................................................................8
3.1 General Objective..............................................................................................................................8
3.2 Specific Objectives.............................................................................................................................8
Chapter Four................................................................................................................................................9
Method and Material..................................................................................................................................9
4.1 Study Area.........................................................................................................................................9
4.2 Study Period......................................................................................................................................9
4.3 Study Design......................................................................................................................................9
4.4Source population.............................................................................................................................9
4.5 Study population...............................................................................................................................9
4.3Inclusion and exclusion criteria..........................................................................................................9
4.3.1 Inclusion criteria.........................................................................................................................9
4.3.2 Exclusion criteria.........................................................................................................................9
4.7 Sample size determination and sampling technique.........................................................................9
4.7.1 Sample size.................................................................................................................................9
4.7.2 Sampling technique..................................................................................................................10
4.8 study variables.................................................................................................................................11
4.8.1 Dependent variable..................................................................................................................11

IV
 4.8.2 Independent variable................................................................................................................11
4.9 Data collection.................................................................................................................................11
4.10 PRE-TEST........................................................................................................................................11
4.11 Data processing, presentation and analysis...................................................................................11
4.12 Dissemination of the results..........................................................................................................12
4.13 Ethical consideration.....................................................................................................................12
4.14 Operational definitions of terms....................................................................................................12
Chapter Five..............................................................................................................................................13
Project Work Plan......................................................................................................................................13
Chapter Six................................................................................................................................................14
Budget Proposal........................................................................................................................................14
Annex I.......................................................................................................................................................16
Dummy Tables..........................................................................................................................................16
Annex II......................................................................................................................................................19
References.................................................................................................................................................19
Annex III.....................................................................................................................................................21
Questionnaire............................................................................................................................................21

V
List of Tables
Table Page
Table 1: Shows Socio demographic data of food handlers working at students’
cafeteria in Bahir dar University, all campuses, April 2014...................................16
Table 2: Shows work experiences of food handlers working at students’ cafeteria
in Bahir dar University, all campuses, April 2014..................................................17
Table 3: Shows Level of knowledge of food handlers on food handling and food
born disease, working at students’ cafeteria Bahir dar University, all campuses,
April 2014................................................................................................................17
Table.4 Distribution of Personal hygiene practices before and during food
handling of food handlers working at students’ cafeteria in Bahir dar University, all
campuses, April 2014……………….......................................................….18
Table 5: Distribution of Medical checkup practice of the food handlers working at
students' cafeteria in Bahir dar University, all campuses April, 2014……….......…
18

VI
Acronyms and Abbreviations
AAU-Addis Ababa University
AFI-Acute Febrile Illness
AGE-Acute Gastro-Enteritis
AMRF-Africa Medical Research Foundation
ARI-Acute Respiratory Infection
CDC-Communicable Disease Control
FDRE-Federal Democratic Republic of Ethiopia
GIT-Gastro-Intestinal Tract
HACCPS-Hazard Analyze Critical Control Point System
HIV/AIDS-Acquired Immune Deficiency Syndrome
ICT-Information Communication Technology
IP-Intestinal Parasite
KAP-Knowledge, attitude, practice
MOH-Ministry Of Health
SRP-Student Research Program
STI-Soft Tissue Injury
US-United State
UTI-Urinary Tract Infection
WHO-World Health Organization

VII
 CHAPTER ONE
INTRODUCTION

1.1 Background
Although food is a basic human need it can sometimes cause a number of illnesses
arising from pathogenic or toxic substances, which find their way in to food through
contamination or spoilage(MOH,2004). Infections or toxic related diseases, which are
caused by an agent that enter the body through ingestion of food is called "food-borne
diseases" .When one says food borne disease it does not mean that the food itself
transmit disease, it means that the food is not handled in clean condition; hence the food
becomes contaminated by disease causing microorganisms or chemical
poisons(AMRF,1997).

To achieve the public health goal of reducing food borne diseases to the fullest extent
possible, steps must be taken at each point in the food chains where hazards can occur.
The role of food handlers on this food safety journey is a crucial one. Thus they should
receive training on good food handling and practice the fundamental rules of food
handling. Food handler is any person who involved in the storage, manufacturing,
preparation, handling, sales or serving of food in a manner where his/her body or hand
comes in contact with food or utensils(WHO,2011).

Food handlers should be kept under regular survelleince .Food handlers who have
infected wounds or sores or suffering from GIT illnesses or any other condition likely
to cause the contamination of food or food contact surfaces,or who have been in
contact with a person suffering from a food or water borne diseases, should report
immidiately to the management;they should be excluded from food handling until
given medical clearance to return to work. Mort Lock et al.(1999).
All persons Applying for jobs as food handlers should undergo a pre-recruitment
medical examination and a professional assessment should be made of their clinical
hitory.Only those who are free from infection and are proved not to be carriers should
be engaged(Teka.1997).
1
1.2 Statement of the problem
Among our daily activities, the main one is preparation of food. The food we prepare
and utensils in which we prepare food have direct relation to our health. If the food
utensils and food equipment for preparing food are not maintained in clean conditions,
they are likely to be the multiplying media for disease causing agents. Therefore when
using those utensils and equipment, we can easily be exposed to the risk of
disease(MOH,2004).Hence, in order to prevent food borne diseases, all food handlers
have to apply the following basic principles(WHO,2011) regarding the cleanliness of
food and food utensils and equipment:
 keep clean
 separate raw and cooked foods
 cook carefully
 keep food at safe temperature
 use safe water and raw materials
Food borne diseases are one of the major public health concerns worldwide today.
However, the actual impact and magnitude in health are not exactly known because of
only small proportions of cases are reported (Ammanuel,1997;Marriot,1999). It is
believed and proven that food is crucial and vital substance for the normal activity of
each body cell (Negash,2004).However, sometimes it could be the risk of deadly
diseases through contamination and chemical poisoning (WHO,1992).Diarrheal
diseases mostly caused by food and drinks contaminated with microbial pathogens are
the leading cause of illness and deaths in developing countries (Sofnias and
Ayalew,2006). Moreover, dehydration which is the devastating complication of
diarrhea is one of the principal causes of death in developing countries
(Bekele,2005).People are often weakened by malnutrition and parasitic infections
especially children are the main victims that can suffer more from those problems
(AMRF,1997).Contaminated food is the most common cause of illness in the world
today (Oteri et al.1999;Ekanem,1999).

2
Although Food handlers who are working in the food and drinking establishments are
the most crucial personnel on food and drink borne diseases (Lugose,1989)most of
them are not well trained on proper food processing and preparation(Ammanuel,1997).

Moreover, they do not practice regular hand washing before and after food preparation
(Ammanuel,1997;Andarge et al.2004). Good personal hygiene of food handlers is the
standard criteria of effective food hygiene (WHO,1999). Every food handler must take
all the precaution necessary to protect food and drink from contamination
(Barak,2004;Teka, 1997).

Handlers who work in most food and drinking establishments are not following the
basic precaution routinely because of low level of knowledge, attitude and practice
(Journal,2001; mekete,2001).Nearly all ordinances and codes required that all food
handlers should be free from communicable disease; handle food in accepted hygienic
manner and should practice meticulously the rules of food hygiene
(Kebede,2005;WHO,1999 and Adams,1974). Food handlers with low level of
knowledge and practices on food and poor personal hygiene could be potential
continuous source of food born disease for large proportion of peoples
(Teka,1997;Kebede,2005; mekete,2001).

Food borne diseases like other diseases are common public health problems in the
world today, specifically in developing nations including Ethiopia (Sofnias and
Ayalew,2006;Teka,199).
Diarrheal diseases which originates from food and drinks contaminated by human
fecal matters, sewage and other dirties directly or indirectly through unclean hands,
equipments and clothing are most wide spread in most society. Therefore food handlers
are the most crucial personnel for the positive and negative outcomes of food and drink
associated issues (Teka,1997).

3
In Ethiopia like other developing nations the disease condition that are associated with
food and drinks are huge. Beside the existing food and drink borne disease, reporting
system does not clearly and quantifiably indicate the numbers of cases
(WHO,1992;Teka,1997). Food handlers have a major role in the prevention of food
poisoning during food production and distribution phase (Smyth,1986).

In most health organization there are several cases presented with the complaint of
vomiting and diarrheas as a result of food contamination. Like in other parts of the
community there are diarrheal diseases like Ascariasis, Ameobiasis, Giardiasis,
Typhoid fever, Shegellosis and others here in Bahir dar University campuses students
directly or indirectly as a result of food and drink contamination(Health Record,2006).
Therefore, the extent of this problem need to be given attention and studied.

1.3.Significance of the Study

Food borne diseases continued to be one problem of our planet. Even it is greater
problem involving the developed countries and high concern was given until now.
Knowledge, attitude and practice of food handlers towards food handling and food
borne disease in Ethiopia have not been extensively studied, although there are
numerous morbidity and mortality as a result of food-borne disease. Therefore, this
study will try to fill the gaps by assessing factors and point out the problem.
The result of the study will be used:
 To provide information for health planners and professionals for designing
appropriate intervention
 As baseline data for further action research in the area

Chapter Two
4
2.1 Literature Review
It is important to have understanding of the interaction on prevailing food safety beliefs,
knowledge and practice of food handlers in order to minimize food borne outbreaks
(WHO,2000).Mort Lock et al.(1999) stated that there was general agreement revealed
from several authors as good level of knowledge toward food safety among food
handlers and the effective practices of such knowledge in food handling were vital in
ensuring the production of food in any catering operation. Recently many studies
pinpoint the need for training and education of food handlers in public hygiene,
measures due to their luck of knowledge on the microbiological food hazards,
temperature range of refrigerators, cross contamination and personal hygiene (Bas et
al.2004; Nel et al. 2004).Education on food safety should be given to all staff in food
processing business so as to bring behavioral changes beside adoption of positive
attitudes.(Coleman and Roberts 2005;Powell et al.1997). But in some previous studies
no differences were detected between the staff who attended an educational course with
those who did not (Angelillo et al.2001; Askarian et al.2004). This statement is
supported by several studies (Howel et al.1996;Powell et al.1997) and indicate that
although training may increase the knowledge of food safety, this does not always
produce a positive change in food handling attitudes.

Infections or toxic related diseases, which caused by an agent that enters the body
through ingestion of food is called "food-borne diseases" (Kebede,2005;WHO,1999).
World health organization (WHO) expert committee on food hygiene has given
different methods and means of keeping good food hygiene and sanitation (Andarge et
al.2001). All means and measures necessary for insuring the safety, wholesomeness and
soundness of food should be kept properly at all stages: from producing or
manufacturing up to final human consumption (Teka,1997;Andarge et al.2001).

The expert committee declared ten golden rules of safe food preparation for every food
handlers:- 1) Choose food processed for safety 2) Look thoroughly 3) Eat and drink
those cooked foods immediately, 4) Store food properly 5) Re-locate cooked foods, 6)
Avoid contact between raw and cooked foods, 7) Wash hand, utensils repeatedly and
properly, 8) Keep all kitchen surfaces and parts meticulously clean, 9) Protect food
from insects, rodents and other animals, 10) Use pure and clean water, utensils and
containers for food preparations (Andarge et al.2001).

5
The main objective of food hygiene is to ensure the wholesomeness of food, prevention
of offensive and defective in quality of food, reduce economical and nutritional losses
and disease risk (Kebede,2005;Holbs,1974).

Most of the time multiplication and spread of organisms that can cause food borne
disease is directly or indirectly through human poor sanitation behaviors
(Teka,1997;Andarge et al.2001;Tsega and Nadew,1972).
Some study shows that most of food handlers are not practicing the basic rules of food
hygiene as a result of low level of awareness, attitude and educational based practice
(WHO,1992;Teka,1997).

As a rule nearly all ordinances and codes on food hygiene require the food handling
personnel to be free from communicable disease, superficial wounds or lesions on the
body(Smyth,1986).Strict personal hygiene and accepted food handling practice are vital
component of safe food service activities by food handlers but still not develop by large
proportion of handlers who are working in public food and drink service
establishments. They become the source of food born disease to many people
(WHO,1992;Teka,1997;Lugose,1989).All food types can be contaminated, but
perishable and semi perishable foods are the most contaminated foods than non-
perishable (stable) food (Adams,1974;Fraise and Wasion,2001).

Food borne diseases transmission occur mostly through unapparent fecal contamination
of food, water and hands (Fraise and Wasion,2001). Even very small amounts of feces
can carry enough organisms to establish infection (Adams,1974). Contaminated food
may small look and test normal and yet harbors diseases (Sofnias and
Ayalew,2006;Health Record,2006;Faris and Legese,2002). Apparently clean hands may
carry and transmit enough micro-organisms to spread disease (mekete,2001).

Food can be directly or indirectly contaminated via polluted water, dirty hands,
contaminated soil flies and animal or animal products (Barak,2004;Teka,1997;Oteri and
Ekanem,1989).In some countries public health officials force regular medical checkup
of food handlers and certify of a medical certificate to the effect that they are free from
communicable diseases (Teka.1997). The certificates are usually valid for a period of
time but in most parts of our country these type of habit, beliefs and attitude are not
developed well (Teka,1997).Most of food handlers do not have proper knowledge and
6
skill of food handling. Food handlers should have reasonably good knowledge on the
cause, risk factors, mode of transmission and manifestations of food borne disease;
however their level of knowledge and practice in their work did not correspond with the
rule of food hygiene. The responsible regulatory body regular monitoring and
supervision of the handlers and the establishments have a positive influence on the
personal hygiene and food handling practice of food handlers. Establishment whose
kitchen had been pecked had better storage conditions for food prepared and to
relatively clean utensils (Barak,2004;Teka,1997).

The discrepancy between knowledge and practice from the concept of food hygiene
may be explained by a few factor including; handlers reluctance to practice what they
know due to negligence, lack of attitude change and lack of enough encouragement.
They might not be equipped and/or supplied with necessary materials and to maintain
the standard food hygiene type (Teka,1997;Andarge et al.2001).

In order to promote positive attitude of handlers alternative educational strategies such

as those based onmotivational health education and promotion models are
required(Angelillo et al.2001;Askarian et al.2004;Cloyton,2002).If food handles take
serious note on the cleanliness of their hands, body and clothing, this will help in
preventing the incidence of cross-contamination from occurring(Sneed et al.2004).

Chapter Three
Objectives
3.1 General Objective
To assess knowledge, attitude and practice of food handlers on food handling and food
borne disease working at student cafeteria in All bahir dar university campuses.
3.2 Specific Objectives
 To assess knowledge of food handlers on food handling and food borne
diseases.
 To assess attitude of food handlers on food handling and food borne
diseases.
 To assess practice of food handlers related to food and food borne disease
prevention.

7
 Chapter Four
Method and Material
4.1 Study Area
The study will be conducted in BDU, In all campuses students' cafeteria, which was
found in Bahir dar town, Amhara region, approximately 578 km north-northwest of
Addis Ababa (Ethiopia). Bahir Dar University was established by merging two former
higher education institutions; namely the Bahir Dar Polytechnic and Bahir Dar
Teachers’ College. Polytechnic Institute, which has transformed itself into Technology
and Textile institutes, was established in 1963 and The Bahir Dar Teachers’ College, by
then known as the Academy of Pedagogy, was established in 1972.There is student’
cafeterias in campus having 350(??) food handlers and serving around 7500(??)
students.
4.2 Study Period(??????????)
Data will be collected from May 17-20, 2014.
4.3 Study Design
A cross sectional descriptive study will be conducted.
4.4Source population
All food handlers working at students’ cafeteria of BDU, All campuses.
4.5 Study population
Food handlers working at students’ cafeteria of BDU, All campuses will be included in
the study and they will be selected by systematic random sampling.
4.3Inclusion and exclusion criteria
4.3.1 Inclusion criteria
All cafeteria workers available at the time of data collection
4.3.2 Exclusion criteria
Those who are absent at the time of data collection.
4.7 Sample size determination and sampling technique
4.7.1 Sample size

8
A single population proportion formula was used by considering the following
assumption: 50% proportion, 5% margin of error, 95% confidence interval at normal
distribution

{ Z ( p ( 1− p ) )
}
2
n= 2
d

GIVEN

z=1.96 p=0.5 d=0.05

( 1.96 )2 (0.5(1−0.5))
n= 2
(0.05)

(3.8516)(0.25)
n=
0.0025

n=385.16 .5 ≈ 386

The minimum sample size required is 386 subjects.

Since total population is <10, 000, the correction formula was used.
n
n=
nf =n/ [1+ (n/N)] [1+(
n
)]
N
386
nf =384/ [1+ ( 384/350)] n= [1+( 386 )]
??
nf =183:by considering non-response 5% of nf will be added; 183*5%=9,the final
sample required for the study;
183 +9= 192
Where
N =total number of food handlers=350
n = the minimum sample size required=384
Z= value corresponding to 95% confidence interval i.e.1.96
Z=Zα/2=1.96
P=50%was used for prevalence value because there was no research done near this area.
q=1-p=50%
d= margin of error
nf = final sampling size=192

9
4.7.2 Sampling technique
A simple systematic random sampling technique will be used to select the study
population.
4.8 study variables
4.8.1 Dependent variable
Knowledge
Attitude
Practice
4.8.2 Independent variable
Educational status
Age
sex
Religion
Working experience
Marital status
Income
Training
Working environment
4.9 Data collection
An English version of pre-structured questionnaire will be prepared, translated to
Amharic language to collect the required information. Data will be collected by
graduating class comprehensive adult nursing students. Orientation will be given before
the actual data collection by the principal investigator.(??????)
4.10 PRE-TEST
A pre-test will be done by principal investigator on 5% of total sample size one week
prior to actual data collection and checked daily for consistency and accuracy,
inappropriate questions will be corrected for final data collection. Training will be
given for data collectors that they will check each filled questionnaire for completeness,
missed, ambiguous and illegible answer.
4.11 Data processing, presentation and analysis
The raw collected data will be processed manually using pocket calculator. These data
will also be compiled, organized and presented in tables and graphs. The finding of the
10
study will be analyzed using statistical tools such as chi-square (Chi-x2) test and finally
interpreted using standards and compared with other similar studies.
4.12 Dissemination of the results
After data analysis is completed and feasible recommendation will be made, the result
of the study will be disseminated to bahir dar University student research program,
comprehensive adult health nursing department office, Supervisors and may be used as
a base line data for those who want to do further research in this area.
4.13 Ethical consideration
A formal letter will be written by BDU SRP and submitted to the students’ cafeteria
manager and the objective of the study will be explained to the manager. Before data
collection process, permission from the students’ cafeteria manager, and to all study
participants and consent will be obtained verbally.

4.14 Operational definitions of terms

Good knowledge: If respondents correctly answer at least greater than 75% of
questions related to knowledge.
Fair knowledge: If respondents correctly answer at least 50% and less than 75%
of questions related to knowledge.
Poor knowledge: If respondents correctly answer less than 50% of questions
related to knowledge.
Positive attitude: if respondents had positive answer for questions related to
attitude.
Negative attitude: if respondents had negative answer for questions related to
attitude.
Good practice: If respondents correctly answer at least greater than 75% of
questions related to practice.
Fair practice: If respondents correctly answer at least 50% and less than 75% of
questions related practice.
11
 Poor practice: If respondents correctly answer less than 50% of questions
related to practice

Chapter Five
Project Work Plan
N Activities Responsibl Oct Nov Dec Jan Feb Mar Apr Ma Jun
o e person . . . . . . . y e
1 Topic 
selection PI
2 Proposal PI 
developmen
t
3 First draft PI 
proposal
submission
4 Final PI 
proposal
submission
12
5 Budget PI 
allocation
6 Data PI 
collection
7 Data PI 
analysis,
report and
writing
8 First draft PI 

9 Report PI 
submission
10 Final paper PI 
submission
11 Presentation PI 

12 Monitoring PI and 
advisor
KEY: PI= Principal Investigator

Chapter Six
Budget Proposal

No Description No of No of days Cost (one) Total

participan
ts
Birr Cent Birr Cent
1 Personal data 2 1 30 00 60 00
collectors
Orientation

Data collections 2 3 30 00 180 00

13
 Secretary 1 10 40 00 400 00

Principal 1 3 30 00 90 00
investigator
Sub total 6 130 00 730 00

2 Stationary Unit Quantity Birr Cent Birr Cent

Duplicating Packet 1 pack 70 00 70 00

paper
Pen No 2 4 00 8 00

Pencil No 1 2 00 2 00

Eraser No 1 2 00 2 00

Floppy No 2 6 00 12 00

Sub total 84 00 94 00

4 Contingency 5% of total 46 00

5 Grand total 870

Budget Summery

Category Total(birr)

NO

1 Human resource 730

2 Stationary 94

3 Contingency 46

Total 870

14
 Annex I
Dummy Tables
Table1. Socio demographic data of food handlers working at student’ cafeteria in
Jimma University, Keto Furdisa campus, April 2014.

No % Remarks
<20 years
Age
>20 years
Sex Male
Female

15
 Oromo

Kaffa
Ethnicity
Gurage

Silte

Amhara

Tigre

No formal
education
Education
al
status Primary school

Secondary
school

Others

Training Yes
course
No

Table 2: Work experience of food handlers working at students’ cafeteria in Jimma

University, Keto Furdisa campus, April 2014.

Work experience Number %

as food handlers
Less than a year

16
 One to two year

Three to four year

Greater than four year

.
Table 3: Shows Level of knowledge of food handlers on food handling and food born
disease, working at students’ cafeteria in Jimma University, Keto Furdisa campus, April
2014.

Knowledge No %

Good knowledge
Poor knowledge

Table 4: Distribution of Personal hygiene practices before and during food handling of
food handlers working at cafeteria in Jimma University, Keto Furdisa campus, April
2014.

Frequency Activities
Hand washing Gown Hear covering
wearing
Always
Sometimes

Never

17
Table 5: Distribution of Medical checkup practice of the food handlers working at
students’ cafeteria in Jimma University, Keto Furdisa campus April, 2014.

Medical checkups No %

Regular checkup

No Regular checkup

Annex II
References
Adams H.S.1974 G.C."Milk and food sanitation practice" New York.
Afric Medical Research foundation,1997G.C.PP 157-212.
Angelillo.I.F. Viggaini, M.A., Greco,R.M. and Rito.D.,2001.HACCP and food hygiene
in hospital:KAP of food service staff in Calabria, Italy .Infection control hospital
epidemiology 22:1-7
Askarian, M.,Kabir. G.,Aminbaig. M.,Memish. Z.,andJafari.P. 2004.KAP of food
service staff regarding food hygiene in Shirez,Iran. Infection controlhospital
epidemiology 25:16-20
BekeleKebede, 2005. "Introduction To Environmental Health "For Health science
students,(lecture note):109-144

18
Clayton.D.A., Griffith. D.J., Price. P. and Peters.A.C. 2002.Food handlers belief and
self-reported practices .International journal of Environmental health research 12:25-39.
Dr.SofniasGetachew and Dr.Ayalew Tegegn,2006 G.C."Communicable disease control
for Health officer students" lecture note: PP143-167
JimmaUniversity,Keto Furdisa campus student clinic health record,2006(not published).
Fraise W.C.and wesionF.D.C."Food Microbiology" Taka McGraw-HIV publishing
company limited 3rd edition, New Delhi.
Federal Democratic Republic of Ethiopia, MOH,2004 G.C. "Food hygiene and safety
measures".
GashawAndarge ,Afowork Kassa, Feleke Moges, Moges Tiruneh and Kinsoy Huruy,
"Prevalence of intestinal parasites among food handlers" in Gonder Town ,North
Ethiopia.
Gebre Emmanuel Teka,1997 G.C. "Food hygiene principles and methods of food borne
diseases control" spatial reference to Ethiopia, A.A.
Holbs B.C.1974 .G.C. food poisoning and food hygiene in the prevention of food borne
diseases, Edward Arnold published London, Colchester and Bescles 3rd edition.
JemilHassen, 2010. "Assessment of knowledge, attitude and practice of food handlers
on food handling and food borne diseases at MekeleTown(un published).
Jimma University, Keto Furdisa campus student clinic health record,2006(not
published).
KebedeFaris and worku Legesse , 1996 E.C ."Food hygiene and control".
Lugose,W.L.The international new letter on the control of diarrheal diseases, March,
1989.
Marriot N.G.,1999 G.C."Sanitation principles of food," Aspen publishers in C.Maryind
4th edition.
Negash Barak.2004 G.C. "Food hygiene" For environmental health science students,
lecture note series, Haramaya University, Ethiopia.
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Public Health;pp158-159.
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cyst and larva of intestinal parasites from food handlers" working in student cafeteria in
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diseases Cambridge University Press,UK.

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Annex III
Questionnaire
I am graduating class, student of comprehensive adult nursing in Bahir dar University. I
would like to ask you participate in this study which is intended to collect information
in your cafe. Whatever information you provide will be kept strictly confidential. I
greatly appreciate your full participation in filling the questionnaire.
Do you agree?
Yes No
Approximate time it takes 20 min.
Part I
1 Demographic data
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1.1 Age ……

1.2 Sex male

Female

1.3 religions
a) Orthodox b) Muslim c) protestant d) catholic e) other (specify)…..
1.4 Ethnicity
a) Oromo b) Amhara c) Gurage d) Kaffa e) Tigre f) other (specify)
1.5 marital statuses
a) Single b) married c) divorced d) widowed
1.6 Educational statuses
a. 1-4grade b. 4-8grade c.8-12 d).above 12
Part II
2. Knowledge related questions
2.1 Have you ever heard about food born disease?
a) Yes b) No
2.2 If you say "yes" to Q 2.1 do you know about its severity?
a) Yes b) No
2.3 Do you know the causative agents of food borne diseases?
a) Yes b) No
2.4 If you say yes to Q 2.3 which of the following causative agent do you know?
a) amoeba b) cholera c) gardia d) shiggella e) botolism f) other (specify)
2.5 Do you know the commonest reasons of food contamination?
a)Yes b)No
2.6 If your answer is yes to Q 2.5which of the following reasons do you know?
a) poor personal hygiene of food handlers
b) improper storage
c)cross contamination of raw and cooked foods
d) long stay of food before consumption
e) all
2.7 do you know commonest manifestations of food borne diseases?
a) Yes b) No
2.8 If your answer is yes to Q 2.7 which of the following is manifested?
a) Diarrhea b) vomiting c) abdominal pain d) all
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2.9 What are the basic requirements of food handling?
a) Education on proper handling
b) good Personal hygiene
c) Regular medical checkup with 4 month intervals
d) a& c
e) All
2.10 do you know the relation between food handler and food born disease?
a)Yes b) No
2.11 If your answer is yes to Q 2.10 can you briefly explain the relationship between
food handlers and food born disease? ......................................
2.12 do you know a food handler should have medical checkup?
a)Yes b)No
2.13 If your answer is yes for Q 2.12, when a food handler should made a medical
checkup?
a) before employment b) quarterly c) at least 2times per year d) all
2.14 If your answer is yes to Q 2.12 which sample was taken for laboratory
investigation?
a) Urine b) stool c) blood e) all
Part III
3. Attitude Related Questions
3.1 Are you interested of being a food handler?
a)Yes b)No
3.2 If your answer is No Q 3.1 what is the reason?
a)Salary b)Employer c) Other specify………
3.3 If your answer is yes to Q 3.1 what is the reason? Can you specify it briefly?
………………………………………………………………………
3.4 Keeping raw and cooked food separate helps to prevent illness.
a) True b) False
3.5 How you become food handler?
a) For income
b)peer pressure
c) other specify ……………………………
3.6 Do you think personal hygiene of food handlers have vital role towards transmission
of food borne disease?
a) Yes b)No
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3.7 Some food handlers believe food will be poised when it is closed, do you agree?
a)Yes b)No
3.8 Some people says most medical checkup do not have value for food handlers do you
believe like that?
a) Yes b) No
3.9 Do you believe washing hands before starting food preparation has importance?
a)Yes b) No

Part IV
4. Practice Related Questions
4.1 Do you routinely wash your hand with soap before and after toilet?
a)Yes b) No
4.2 How many times do take body bath per week?
a)>3 times b)<3 times
4.3 Do you have time for your hair and nail hygiene?
a) Yes b) No
4.4 Do you wear working uniform while handling food?
a) Yes b)No
4.5 Do you wash each utensil after one use?
a) Yes b) No
4.6 Do you use washing brush or sponge?
a) Yes b) No
4.7 Do you boil the water for washing utensils?
a) Yes b) No
4.8 How many washing basins do you use to wash food utensils?
a) 3 basins b) <3 basins
4.9 For how many years you are worked as food handler?
a) ≤ 1 year b) 1-2 years c) 2-3 years d) > 3 years

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