{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T22:50:41Z","timestamp":1784242241107,"version":"3.55.0"},"reference-count":50,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,6,10]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study was conducted to assess the prevalence of intestinal parasites and the associated factors among food handlers in the Lideta subcity of Addis Ababa, Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An institution-based, cross-sectional study design was used. Stool samples were collected from food handlers and examined using direct wet mount and formalin-ether concentration techniques. Personal and establishment-related information was collected using a pretested questionnaire, with a structured observation. Multivariable binary logistic regression was used to identify factors associated with the prevalence of intestinal parasites on the basis of adjusted OR (AOR) and 95% CI and p values &lt;0.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Food establishments in the Lideta subcity of Addis Ababa, Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>411 food handlers participated in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was the prevalence of intestinal parasites, defined as the presence of one or more intestinal parasitic species in stool samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One or more intestinal parasites were detected in 171 (41.6%; 95%\u2009CI 36.6% to 46.4%) stool samples. The most common intestinal parasites were\n                      <jats:italic>Entamoeba histolytica\/dispar<\/jats:italic>\n                      (12.7%),\n                      <jats:italic>Giardia duodenalis<\/jats:italic>\n                      (11.2%) and\n                      <jats:italic>Ascaris lumbricoides<\/jats:italic>\n                      (8.3%). The presence of intestinal parasites among food handlers was associated with low monthly income (AOR: 2.83, 95%\u2009CI 1.50 to 8.84), untrimmed fingernails (AOR: 4.36, 95% CI 1.98 to 11.90), no food safety training (AOR: 2.51, 95% CI 1.20 to 5.58), low level of education (AOR: 3.13, 95% CI 1.34 to 7.44), poor handwashing practice (AOR: 2.16, 95% CI 1.03 to 4.22) and lack of medical check-up (AOR: 2.31, 95% CI 1.18 to 6.95).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of intestinal parasites among food handlers in food establishments in the Lideta subcity of Addis Ababa was high. The presence of intestinal parasites was linked to socioeconomic conditions, poor hand hygiene conditions and absence of food safety training. It is crucially important to promote handwashing practices and provide food hygiene and safety training in these settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-061688","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T11:23:03Z","timestamp":1658316183000},"page":"e061688","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence of intestinal parasites and associated factors among food handlers in food establishments in the Lideta subcity of Addis Ababa, Ethiopia: an institution-based, cross-sectional study"],"prefix":"10.1136","volume":"12","author":[{"given":"Woinishet","family":"Abera","sequence":"first","affiliation":[{"name":"Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binyam","family":"Gintamo","sequence":"additional","affiliation":[{"name":"Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia"},{"name":"Department of Public Health, Addis Ababa Medical and Business College, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5566-204X","authenticated-orcid":false,"given":"Tewoderos","family":"Shitemaw","sequence":"additional","affiliation":[{"name":"Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia"},{"name":"Anesthesia Department, Menelik II Health and Medical Science College, Kotebe Metropolitan University, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelalem Negash","family":"Mekuria","sequence":"additional","affiliation":[{"name":"Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia"},{"name":"Department of Public Health, Addis Ababa Medical and Business College, Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6713-1975","authenticated-orcid":false,"given":"Zemichael","family":"Gizaw","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"2025121404045196000_12.7.e061688.1","unstructured":"World Health Organization (WHO) . Estimating the burden of foodborne diseases. 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Epidemiology of viral foodborne outbreaks: Role of food handlers, irrigation water, and surfaces. In: Viruses in foods. Springer, 2016: 147\u201363.","DOI":"10.1007\/978-3-319-30723-7_5"},{"key":"2025121404045196000_12.7.e061688.6","doi-asserted-by":"crossref","unstructured":"Dreyfuss M . Foodborne or pandemic: an analysis of the transmission of norovirus-associated gastroenteritis and the role of food handlers. Medicine 2009.","DOI":"10.1089\/fpd.2009.0320"},{"key":"2025121404045196000_12.7.e061688.7","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268804002742"},{"key":"2025121404045196000_12.7.e061688.8","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.4315\/0362-028X-70.7.1752","article-title":"Outbreaks where food workers have been implicated in the spread of foodborne disease. 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Training manual on diagnosis of intestinal parasites based on the who bench AIDS for the diagnosis of intestinal parasites, district laboratory practice in tropical countries. WHO\/CTD\/SIP\/98.2 CD-Rom, 2004. 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Use of ash and mud for handwashing in low income communities. The International scientific forum on home hygiene (IFH), 2009. 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