COVID-19 infection prevention practices among a sample of food handlers of food and drink establishments in Ethiopia

BACKGROUND: Cases of coronavirus disease (COVID-19) are increasing at an alarming rate throughout the world, including Ethiopia. Food handlers in food and drink establishments are at high risk of exposure to the virus due to their many daily contacts with customers. Since there is a paucity of evidence about infection prevention practices and associated factors among this high-risk group in Ethiopia including in Dessie City and Kombolcha Town, this study was designed to address this gap. METHOD: An institution-based cross-sectional study was conducted among 422 food handlers in Dessie City and Kombolcha Town food and drink establishments in July and August 2020. The study participants were selected using a simple random sampling technique. Data were collected by trained data collectors using a pretested structured questionnaire and an on-the-spot observational checklist. Data were entered into EpiData version 4.6 and exported to STATA version 14.0 for data cleaning and analysis. Data were analyzed using bivariable and multivariable logistic regression model at 95% confidence interval (CI). From the bivariable analysis, variables with a p-value <0.25 were retained into multivariable analysis. Finally, variables that had a p-value <0.05 were declared as factors significantly associated with good infection prevention practices of COVID-19 among food handlers. MAIN FINDINGS: The overall rate of good practice in infection prevention among food handlers was 43.9% (95% CI: 39.2–48.4%). Among the total 401 food handlers, 79.8% had good knowledge and 58.4% had a favorable attitude about COVID-19 infection prevention. Factors significantly associated with good COVID-19 infection prevention practices were: educational status of college or above (AOR = 1.97; 95% CI: 1.32–3.75), food handling work experience greater than five years (AOR = 2.55; 95% CI: 1.43–5.77), availability of written guidelines within the food and drink establishment (AOR = 2.68; 95% CI: 1.52–4.75), and taking training about infection prevention (AOR = 3.26; 95% CI: 1.61–6.61). CONCLUSION: Our findings showed that around one-third of food handlers had good infection prevention practices. Thus, to reduce COVID-19 transmission, integrated work is urgently needed to further improve food handlers’ good practices, knowledge and attitude about infection prevention through providing health education, training and by making written infection prevention guidelines available in food and drink establishments.