Microbial Contamination and Consumption Patterns of Produce and Street Food Across Ten Cities in Africa, Asia, and the USA Open Access

Erkens, Melissa (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/t722hb05t?locale=en


Foodborne diseases have been increasing globally, despite efforts to improve water, sanitation, and hygiene (WASH) conditions in areas with high disease burden. Food items can become contaminated at multiple points in the farm-to-fork pathway, and improperly prepared or uncooked foods can cause disease. Street food dishes and dishes with raw produce, such as salads, have also become increasingly popular. This analysis aimed to quantify the association between E. coli contamination and type of produce or street food, socioeconomic status (SES), and city where samples were collected, as well as characterize food consumption patterns for adults and children. Produce and street food samples were collected from 44 neighborhoods in ten cities in Africa, Asia, and the USA and analyzed for E. coli using membrane filtration or IDEXX. Sample type, SES, and city were modeled against E. coli concentration using logistic regression at multiple cutoffs. One member of each household surveyed in study sites was interviewed about household produce and street food consumption, and frequencies of behaviors were calculated for adults and children. Herbs, leafy, and root-underground vegetables had significantly higher odds of E. coli contamination above 2.93 log10 CFU/MPN compared to seeded vegetables. Mixed street food dishes had significantly higher odds of contamination above 2.67 log10 CFU/MPN and 2 log10 CFU/MPN compared to cooked dishes. Samples of street food from neighborhoods with higher SES had increased odds of E. coli contamination above 2.67 log10 CFU/MPN and 2 log10 CFU/MPN compared to low SES neighborhoods. Street food samples from Accra, Kampala, and Kumasi had significantly lower odds of E. coli contamination above 2.67 log10 CFU/MPN and 2 log10 CFU/MPN compared to Dhaka. Adults reported similar food consumption patterns between themselves and children in their household across study sites. There was a clear association between uncooked food items and increased odds of E. coli contamination, as well as different odds by SES or city. It is important to address poor food hygiene and understand how it is linked to inadequate sanitation in low-income settings in order to minimize the risk of contamination of popular food items and reduce the burden of foodborne diseases.

Table of Contents

Chapter I: Literature Review 1

Chapter II: Manuscript 19

Abstract 19

Introduction 19

Methods 24

Results 28

Discussion 34

Conclusion 45

References 47

Tables 50

Figures 56

Chapter III: Conclusions and Recommendations 57

Appendices 61

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