Food Hygiene Practices Among Preschool Food Handlers in eThekwini, KwaZulu Natal, South Africa: A cross-contamination perspective

Background Early childhood care and proper nutrition play a significant role in a child's development. Poor food handling practices may result in potential foodborne illnesses and even death. Children are more prone to such illnesses as they are a vulnerable group and are still developing. Objectives This study investigated the levels of food safety practices at registered Early Childhood Development Centres (ECD) within eThekwini communities with the objective of determining the relationship between understanding cross-contamination in relation to knowledge and behaviours of food handlers at the ECD centres. Methods This cross-sectional study was conducted at ECDs in eThekwini, Kwa Zulu Natal Province, South Africa. Using convenience sampling 160 food handlers from 61 ECDs participated in the study. The data was collected using the World Health Organisation's 5 Keys to Safer Foods self-administered questionnaire and analyzed for frequencies, means, and relationships. Results The study revealed that while food handlers in pre-schools showed positive attitudes toward hygiene, there were significant gaps in knowledge and behaviour. For instance, 69.2% believed a cutting board was safe for raw and cooked foods if clean ( p  = 0.003), and only 55% used separate utensils consistently ( p  < 0.001). Significant correlations ( p  = 0.017) were found between awareness of wiping cloth contamination and the notion that foods should be thrown out once they have passed their expiration date and between cleaning surfaces and equipment before using them again for different foods (p = 0.007). Conclusion The study's findings indicate that, while fundamental hygiene practices are prevalent, participants who understood the concept of cross-contamination and how microorganisms could be spread understood the intricacies of food safety in relation to concerning practices such as separation of foodstuffs, correct thawing and using foods within their recommended usage dates. Such concepts are not always associated with broader food safety knowledge. The results highlight the need for tailored food safety interventions for food handlers and indicate the need for environmental health practitioners to conduct such training focusing on microorganisms, temperature control of foods and cross-contamination to improve the safety of food at ECD centres.