Food Protection Trends - September/October 2021 - 502

Although comprehensive data on the burden of foodborne
disease is limited in Ethiopia, studies in the country have
shown that S. enterica, E. coli O157:H7, Campylobacter
spp., Listeria monocytogenes, and Staphylococcus aureus are
prevalent in animal-source foods (10, 17, 21, 22, 28, 29).
Adequate abattoir facilities and good hygiene standards
are major gaps in the country, posing multiple food safety
challenges (cross-contamination, pathogen harborage within
facilities, etc.) (22).
Beef is the most widely consumed meat in Ethiopia and
is commonly supplied by butcheries, restaurants, pubs,
hotels, and cafeterias (36). Meat safety is an important
concern, because Ethiopians have a deep cultural tradition
of consuming raw or undercooked meat (e.g., " Kitfo " and
" Kurt " ) (11). There is a significant lack of food safety
oversight within urban and rural abattoirs, and general
infrastructure is poor (e.g., no electricity, water, chiller,
refrigerated truck, or hanging rails). In addition, bacterial
contamination during the slaughtering process can originate
from multiple sources but is commonly associated with
poor sanitation of equipment and food-contact surfaces, as
well as poor personnel hygiene (16, 31, 38). Collectively,
these factors might increase the risk of foodborne diseases
associated with raw meat consumption in Ethiopia.
Previous studies in Ethiopia examining food handler's
knowledge, attitudes, and practices (KAP) as it relates to food
safety have mainly focused on public food establishments,
such as hotels, restaurants, cafeterias, butcheries, and juice
houses (7, 13, 34, 40). The few studies that have evaluated the
KAP of abattoir workers have been conducted in the cities of
Mekelle and Jigjiga, which are two regions with significant
cultural and agroecological differences compared with the
rest of Ethiopia (22, 37). To our knowledge, no published
studies have evaluated KAP of abattoir workers in Addis
Ababa, Hawassa, and Dire Dawa, Ethiopia. Therefore, this
study aimed to assess abattoir workers' food safety KAP and
its associated factors.
MATERIALS AND METHODS
Description of the study area
The Addis Ababa Abattoirs enterprise is the largest
facility situated in the capital city of Ethiopia, Addis Ababa.
The Hawassa municipal abattoir is geographically situated
in Hawassa City, south Ethiopia, and the Dire Dawa
municipal abattoir is located in the eastern region of the
country, Dire Dawa City, near Port Djibouti. According
to information from abattoir offices, the average numbers
of animals slaughtered per day at these Addis Ababa,
Hawassa, and Dire Dawa abattoir facilities were 702,
150, and 120, respectively. These abattoir facilities were
purposively selected because of their slaughtering capacity
and location in different regions of Ethiopia with significant
agroecological and cultural differences.
Study design and questionnaire administration
Institutional-based cross-sectional study design was
carried out between March 2019 and January 2020. The
study participants were abattoir workers involved in
meat inspection, supervision, slaughtering, cleaning, and
transportation. The sample size was determined using
the single population proportion formula, considering
the following assumptions: 50% of workers with good
knowledge, attitudes, and hygiene practices toward food
safety, a 95% confidence level, and a 5% margin of error.
The required sample size for this study was 384; after adding
10% for the nonresponse rate, the final sample size was 422.
Finally, the sample size from each abattoir was proportionally
allocated as Addis Ababa (246), Dire Dawa (92), and
Hawassa (84). Systematic random sampling based on an
employee's identification card was used to select participants
for the study.
The data were collected using a structured questionnaire
that was adapted from different food safety studies (9, 20,
26, 37). The questionnaires were categorized into four parts,
namely, (1) sociodemographic characteristics, (2) food
safety knowledge, (3) food safety attitudes, and (4) hygienic
practices of abattoir workers. In the sociodemographic
characteristics section, the education level of respondents
was categorized as informal (participants who didn't have
formal education and never attended school but they
knowledge gained through experience), primary school, and
high school education and above.
In the knowledge section of the questionnaire, 27
questions assessed the workers' understanding of hygiene
practices, contamination sources, potential foodborne
illness outcomes, and temperature control. Each question
consisted of three possible answers: " Yes, " " No, " and " I don't
know. " The scoring criterion for the answers was one point
for each correct answer and zero points for each incorrect
answer and/or " I don't know. " Finally, the total points per
respondent, per section, were calculated as a percentage score
based on the total points possible. Final percentage scores of
respondents were categorized as poor knowledge (≤ 50%)
and good knowledge (> 50%) (2).
For assessing food safety attitudes, 20 statements were
given, and respondents were asked to indicate their level
of agreement to the statements. Responses were rated on a
5-point rating scale, ranging from 1 point (strongly disagree)
to 5 points (strongly agree) for the correct statement and 5
points (strongly disagree) to 1 point (strongly agree) for the
incorrect statement. The corresponding scores assigned to
responses ranged between 20 and 100. The scores of each
respondent were added together and categorized as poor
attitudes (≤60% score) and good attitudes (> 60% score)
with slight modification (2).
For assessing the hygiene practices of respondents, 13
questions were provided with 5-point rating scale: never, rarely,
sometimes, often, and always. The responses ratings ranged
502 Food Protection Trends September/October
Food Protection Trends - September/October 2021

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