Hygiene, Volume 4, Issue 3 (September 2024) – 9 articles

This study assessed knowledge, attitudes, and practices related to food hygiene among mothers from Malawi’s rural communities against the WHO Five Keys to Safer Food (WHO-FKSF) and good pre-and post-harvest practices (GPPHPs) as reference points. Five hundred twenty-two mothers from six rural communities across two districts were selected for the survey. The results indicated limited knowledge among participating mothers regarding managing food hazards, including mycotoxins, bacteria, viruses, and parasites (BVPs). A significant proportion (89.5%) of women reported inconsistent or no handwashing with soap after using the toilet. In addition, 48.7% failed to plant with the first good rains, 38.7% neglected to check for moldy cobs during harvesting, 57.4% dried maize on bare soil, and 99.2% bought maize with noticeable mold. Higher education, knowledge, and positive attitudes were associated with enhanced BVP control practices, while larger households and positive attitudes were linked to improved mold/mycotoxin management (p < 0.05). Mothers showed lower (p < 0.05) knowledge and attitude levels regarding molds than BVPs but demonstrated relatively better practices for mold control. A comprehensive education program based on the WHO Five Keys to Safer Foods, tailored to local socio-cultural norms and incorporating mold and mycotoxin management guidelines, is recommended. Full article

Background: Over the past few decades, epidemic outbreaks and disease occurrences have become more frequent and widespread in Africa, posing challenges for poor countries in the region and impacting vulnerable populations. Limited resources, inadequate healthcare infrastructure, socioeconomic inequalities, malnutrition, mass gatherings, and lack of proper sanitation and hygiene contribute to Africa’s high burden of epidemics and infectious diseases such as cholera, measles, monkeypox, Ebola viral disease, and COVID-19. This paper reviewed epidemic outbreaks and diseases transmitted through intimate contact in Africa and their impacts on vulnerable populations. Methods: A narrative review approach was adopted to gather and analyze the relevant literature on epidemic outbreaks in African sub-regions. The review encompassed causes, transmission patterns, demographic impact, community susceptibility, preventive measures, and psychosocial risk-taking behaviors. Results: This study emphasizes the importance of addressing the causes of response lapses and the resulting human, material, and economic losses in the region. Effective preventive measures include disease surveillance, early mitigation strategies, contact tracing, personal protective measures, improved political and public health leadership, and socioeconomic equity. However, the review highlights challenges in implementing these measures effectively due to limited resources, delayed detection, and difficulties in scaling up response solutions. Conclusions: There is a need for a comprehensive approach involving health departments, infrastructure development, and addressing socioeconomic factors. Full article

Campylobacter jejuni plays a significant role in human health, food production, and veterinary practice. Biofilm formation is a likely mechanism explaining the survival of C. jejuni in seemingly unfavourable environments, but the underlying mechanisms are poorly understood. We propose a mathematical model to unify various observations regarding C. jejuni biofilm formation. Specifically, we present a cellular automaton with stochastic dynamics that describes both the probability of biofilm initiation and its subsequent growth. Our model incorporates fundamental processes such as cell rearrangement, diffusion of chemical compounds, accumulation of extracellular material, cell growth, lysis, and deactivation due to nutrient scarcity. The model predicts an optimal nutrient concentration that enhances population survival, revealing a trade-off where higher nutrient levels may harm individual cells but benefit the overall population. Our results suggest that the lower biofilm accumulation observed experimentally in aerobic conditions compared to microaerobic conditions may be due to a reduced surface invasion probability of individual cells. However, cells that do manage to invade can generate microcolonies of a similar size under both aerobic and microaerobic conditions. These findings provide new insights into the survival probability and size of C. jejuni biofilms, suggesting potential targets for controlling its biofilm formation in various environments. Full article

Habits formed during adolescence tend to persist into adulthood, and correcting poor habits or behaviors during this time is more effective than at other times. Particularly, parents and caregivers should encourage good hygiene habits in their adolescent children by setting a positive example themselves. Using logistic regression, we analyzed the association between brushing teeth after lunch and washing hands before lunch by family type among 54,848 adolescents from the 17th Youth Health Behavior Survey raw data in 2021. Four logistic regression models were used to adjust for confounders hierarchically. In all models, adolescents who practiced tooth brushing after lunch were 2.09 times more likely to practice hand washing before lunch than those who did not. With and without adjustment, we found that the association between adolescents’ tooth brushing and hand washing practices in two-parent households was stronger than the association between adolescents’ tooth brushing and hand washing practices in single-parent households. Associations were found between tooth brushing and hand washing practices, and these associations were higher among adolescents in two-parent households than among adolescents in single-parent households. The finding of a significant link between family type and personal hygiene habits indicates the need for interventions to enhance the oral health of children and adolescents. Such interventions should be customized to reflect the specific characteristics of the child’s household. Full article

The issue of antibiotic resistance represents a significant threat that extends beyond human health, encompassing animal welfare and the sustainability of the natural environment. The inappropriate use of antibiotics, poor sanitation and inadequate control measures have contributed to the emergence of drug-resistant bacteria, which can spread at the human–animal–environment interface. The documented presence of antimicrobials in agriculture, veterinary medicine and human medicine has convinced all stakeholders of the need to contribute to the development of a “One Health” approach, which recognises the interrelationships between animals, humans and their environment and the need to adopt a common strategy encompassing these sectors to limit the spread of bacterial antimicrobial resistance (AMR). Although a number of countries have implemented integrated surveillance systems to monitor antibiotic use and antimicrobial resistance, available data suggest that the use of antibiotics in humans, animals and the environment is increasing worldwide. Consequently, the emergence of antibiotic-resistant pathogens is becoming a recurring concern. This review provides a comprehensive overview of the measures that are necessary to be taken and implemented in order to guarantee global health security. Full article

Environmental monitoring (EM) is the cornerstone for the assurance of sterility during aseptic manufacturing. In this study, the EM quality aspects in the radiopharmaceutical cleanrooms of the University Medical Center Groningen (UMCG), The Netherlands, were evaluated. Hereto, data obtained from EM over the period 2010–2022 were analyzed. The data were sorted according to the Good Manufacturing Practice (GMP) classification of the respective premises with their corresponding limits, and frequencies of excursions were determined per location. The frequency of conducted measurements gradually increased between the start and end of the assessed period. There was a trend of increased action limit excursions observed between 2010–2022. We found that EM in grade A areas appeared to be significantly less compliant with GMP specifications than the combined data from all sampled premises at the facility (p < 0.00001; two-sided Fisher’s exact test). A trend was found for reduced action limit excursions for passive air sampling and particle counting, suggesting improved GMP compliance over time for this specific type of EM. The contamination recovery rate (CRR) found for cleanroom conditions, around 10%, was considered sufficient. From this comprehensive data analysis, we learn that, in order to be fully compliant with the requirements set in the recent revision of EU (European Union)-GMP Annex 1 ‘Manufacture of sterile medicinal products’ (in force as of 25 August 2023), strategies to further improve product protection are justified. For example, improved cleaning and disinfection procedures, more efficient working methods as well as optimization of the conditions under which aseptic manufacturing is performed are to be considered. Full article

Mechanically transmissible and stable viruses such as tobamoviruses, which include Tobamovirus fructirugosum (syn. tomato brown rugose fruit virus (ToBRFV), will continue to pose major challenges for farmers. Consequently, holistic hygiene concepts are being implemented to prevent the introduction and spread of these viruses. The decontamination of tires and castors was previously a weak point in many industrial hygiene concepts. For this reason, the ProfilGate clean-off zone was tested in combination with the disinfectant MENNO Florades for the decontamination of ToBRFV-contaminated tires. In total, 478 tire segments were sampled to evaluate the contamination of ToBRFV and the following decontamination of the tires. This treatment reliably removed high (4.5 µg/cm²), medium (0.45 µg/cm²), and low concentrations (0.045 µg/cm²) of ToBRFV from the tires, as shown by a bioassay. The reduction in necrotic local lesions on susceptible indicator plants N. tabacum cv. Xanthi NN was between 91.9 and 97.6%. The reduction in ToBRFV contamination largely depended on the length of the rollover distance, i.e., the number of tire rotations. For transport trolleys with polyamide and rubber tires, depletions of 97.4 and 97.6%, respectively, was determined after 16 rotations. For transport wagons with tires twice the size and polyurethane tread, the depletion was still at least 91% after eight wheel turns. Even in the case of gross soiling of the tires, the mean reduction from the different tread materials was 80.9 to 98.9%. Subsequent analysis of the clean-off zone revealed that ToBRFV did not accumulate, even when the contaminated tires were driven over several times, but was safely inactivated completely in the disinfectant solution. This provides growers with an effective tool for preventing the introduction and spread of ToBRFV. Full article

In light of the close contact between patient and clinician during ophthalmic examinations and the multiple opportunities for pathogen transmission, we identified and evaluated potential pathogen transmission routes through high-touch surfaces in an outpatient ophthalmology clinic. A circuit simulation was performed to replicate a patient’s journey through an ophthalmology clinic with various stations. Fluorescent oil and powder were applied to the hands of Simulated Patient A who went through the circuit. Routine disinfection of surfaces in the slit lamp environment and hand hygiene by the ophthalmologist were conducted prior to Simulated Patient B going through the same circuit with untagged hands. Ultraviolet black light was used to identify fluorescent marker contamination after Simulated Patient B completed the circuit. Fluorescent marker contamination was found on the hands of all the simulated patients and staff, various items of the simulated patients, multiple equipment surfaces—particularly the ophthalmologist’s working table and slit lamp environment—and miscellaneous objects like appointment cards and files. Fluorescent marker contamination on Simulated Patient B’s untagged hands despite proper hand hygiene being performed prior suggests suboptimal surface disinfection following Simulated Patient A’s circuit. Through this pilot study, we recognised the key role that ophthalmic high-touch surfaces play in fomite transmission and that thorough disinfection of high-touch surfaces is essential on top of proper hand hygiene. With the contact sequences delineated in this pilot study, specific cues for hand hygiene and surface disinfection may be implemented at suitable intervals during contact with high-touch surfaces. Environmental decontamination adjuncts could also be considered to reinforce surface disinfection. Full article

Staphylococcus aureus and coagulase-negative staphylococci account for about 80% of infections associated with medical devices and are associated with increased virulence due to their ability to form biofilm. In this study, we aimed to construct a comprehensive reference map followed by significant pathway analysis in the proteome of S. aureus biofilm grown for 3 days compared with 24 h of planktonic culture using a high-resolution Tandem Mass Tag (TMT)-based MS. We identified proteins associated with secondary metabolites, ABC transporters, biosynthesis of amino acids, and response to stress, and amino sugar and nucleotide sugar metabolism were significantly upregulated in 3-day biofilm. In contrast, proteins associated with virulence factors, microbial metabolism in diverse environments, secondary metabolites, translation, and energy metabolism were significantly downregulated. GO functional annotation indicated that more proteins are involved in metabolic processes, catalytic activity, and binding in biofilm, respectively. Among the significantly dysregulated proteins, hyaluronidase (hysA) in conjunction with chitinase may play a significant role in the elimination and/or prevention of biofilm development. This study advances the understanding of the S. aureus subproteome, identifying potential pathways significant to biofilm biology. The insights gained may aid in developing new therapeutic strategies, including antibiofilm agents, for treating biofilm-related infections associated with implantable medical devices. Full article