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Risk factors for transmission of foodborne illness in restaurants and street vendors in Jakarta, Indonesia

Published online by Cambridge University Press:  08 November 2004

A. M. VOLLAARD
Affiliation:
Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
S. ALI
Affiliation:
Department of Biology, Medical Faculty, Atma Jaya Catholic University, Jakarta, Indonesia
H. A. G. H. VAN ASTEN
Affiliation:
Institute for International Health, Nijmegen University Medical Centre, Nijmegen, The Netherlands
I. SUHARIAH ISMID
Affiliation:
Department of Parasitology, Medical Faculty, Universitas Indonesia, Jakarta, Indonesia
S. WIDJAJA
Affiliation:
Department of Internal Medicine, Atma Jaya Catholic University, Jakarta, Indonesia
L. G. VISSER
Affiliation:
Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
Ch. SURJADI
Affiliation:
Centre for Health Research, Atma Jaya Catholic University, Jakarta, Indonesia
J. T. VAN DISSEL
Affiliation:
Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
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Abstract

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In a previous risk factor study in Jakarta we identified purchasing street food as an independent risk factor for paratyphoid. Eating from restaurants, however, was not associated with disease. To explain these findings we compared 128 street food-vendors with 74 food handlers from restaurants in a cross-sectional study in the same study area. Poor hand-washing hygiene and direct hand contact with foods, male sex and low educational level were independent characteristics of street vendors in a logistic regression analysis. Faecal contamination of drinking water (in 65% of samples), dishwater (in 91%) and ice cubes (in 100%) was frequent. Directly transmittable pathogens including S. typhi (n=1) and non-typhoidal Salmonella spp. (n=6) were isolated in faecal samples in 13 (7%) vendors; the groups did not differ, however, in contamination rates of drinking water and Salmonella isolation rates in stools. Poor hygiene of street vendors compared to restaurant vendors, in combination with faecal carriage of enteric pathogens including S. typhi, may help explain the association found between purchasing street food and foodborne illness, in particular Salmonella infections. Public health interventions to reduce transmission of foodborne illness should focus on general hygienic measures in street food trade, i.e. hand washing with soap, adequate food-handling hygiene, and frequent renewal of dishwater.

Type
Research Article
Copyright
© 2004 Cambridge University Press