Parents’ knowledge, attitude, and practices about food poisoning: a comparative cross-sectional study from Palestine

Supervisor :

Dr.Sa’ed H Zyoud

Abstract :

Background:Food serves as a vehicle of many pathogenic and toxigenic agents that cause what is called a foodborne disease or food poisoning.Knowledge,attitude andpractice (KAP) are the key factors in reducing the incidence of food-borne diseases in foodservice area, they are also influenced by various factors like gender, age, culture, income level, trust in information providers and scientific institutions, and previous experiences.

Objectives:The main objectives of this study were to evaluate the KAP related to food poisoning among parents in Nablus, and to determine the factors associated with KAP towards food poisoning. 

Method:A comparative cross-sectional questionnaire was conducted in primary care centers in Nablus from May to July 2015. From each center, 104 samples were taken. The participants were at least 18 years old, in good mentality and mood, excluding parents who did not give birth or who have children >6 years only. The data was analyzed by SPSS V20 statistical computer program. Poor knowledge was defined as a total knowledge score of 0-7 of 15 questions and good knowledge as a total score of 8-15 of 15 questions. Poor and good attitude were defined as a total attitude score of 0-7 and 8-15 of 15 questions, respectively. Practice scores of 0-10 and 11-20 of 20 questions were considered as un-hygienic and hygienic practice, respectively.

Results:A total of 412 parents were interviewed, 92.7% were mothers. It was obvious from knowledge responses that only 49.0% of the respondents correctly agreed that some toxins produced by microbes and cause food poisoning are resistant to heating temperature of food. After analyzing attitude responses, 36.2% of the respondents wrongly agreed that there is no risk of disease from drinking raw eggs and two thirds wrongly agreed that baby feces are free from pathogenic microbes if he/she is not sick. About forty-six percentage agreed that rainwater collected in reservoir is safe to drink without any treatment and 43.7% agreed that there is no risk of disease from eating cooked food kept at room temperature for one day if covered. About one quarter of the respondents may eat half-cooked eggs and about twenty percent of them may eat raw white cheese prepared from raw un-pasteurized milk. More than one third of the respondents may eat fresh vegetables and fruits after just wiping it, without washing it or pick up it from the plants during a field trip and eat it without washing. All these were un-hygienic practices found between respondents. A significant modest positive correlation was shown between respondents knowledge and attitude scores of food poisoning (r=0.240, P<0.001), knowledge and practice scores of food poisoning (r=0.227, P<0.001) and between attitude and practice scores of food poisoning (r=0.303, P<0.001). The respondents generally have good knowledge, good attitude and hygienic practices (96.12%, 90.77% and 98.30%, respectively).  As long as the educational level increased and residency situation improved, knowledge increase (p-value=0.001and 0.000, respectively). Attitude improve as educational level increased (p-value=0.005), and income level increased (p-value=0.003). A hygienic practice towards food poisoning is higher in female than male (p-value=0.001), and among not working consumers living in village than employed ones (p-value=0.010 and 0.000, respectively).

Conclusions:This study shows that the respondents generally have good knowledge, good attitude and hygienic practices. Highly educated respondents and those who live in cities or villages have better knowledge than others. Moreover, highly educated respondents and those with high-income levels have better attitudes. Unemployed females, as they have higher chance to prepare food in home, living in village are more likely to have hygienic practices. Some issues were noticed and should focus on it:eating raw eggs and white cheese made from raw unpasteurized milk, not washing fruits and vegetables before eating, collecting rainwater in reservoirs without any treatment, and improper handling of cooked leftovers. Another important point is that baby feces is not free from pathogenic microbes even when they are not sick. These findings can be used as baseline for further investigations.