Food-Handling Practices and Environmental Factors Associated With Food Contamination Among Street Food Vendors in Nairobi County, Kenya: A Cross-Sectional Study

BACKGROUND: Lack of adequate sanitation and refuse disposal facilities are among the factors found to contribute to food contamination among street food vendors. Most vending facilities are near crowded places, such as bus terminals or markets to attract consumers, and the few basic amenities, such as toilets, are inadequate. The objective of the study was to determine which sanitation practices were associated with food contamination in Githurai and Gikomba markets in Nairobi County. METHODOLOGY: Using a cross-sectional study design, we systematically randomly sampled 149 street food vendors and used questionnaires to interview them and make observations. RESULTS: A significant negative association was observed between access to a toilet facility and food contamination (P<.001), with a decreased risk of occurrence of food contamination observed where vendors had access to a toilet facility (OR 0.095; 95% confidence interval [CI], 0.039–0.227). Accessibility of running water around the toilet facility was negatively associated with food contamination (P<.001), with vendors who reported access to running water having a lower occur-rence of food contamination (15.9%) compared with those who had no access to running water (30%). Presence of pests/rodents was significantly associated with food contamination (P<.001), with vendors who reported presence of pests/rodents having a 5.9-fold risk (OR 5.921; 95% CI, 2.831–12.383) of contaminated food. Access to fresh running water while preparing food, hand washing before handling food, and use of an apron were the food-handling practices that were negatively associated with food contamination (P<.005). Use of a head cover, hand washing after handling raw food, and the way food was served and stored had no statistically significant association with food contamination (P>.05). CONCLUSIONS: Access to a toilet facility and availability of running water within the toilet facility decreased the likelihood of food contamination. The presence of pests/rodents had a positive association with food contamination. There is a need for more basic amenities, especially toilets and water facilities, within these markets, as well as sensitisation on pest control.