Foodborne disease hazards and burden in Ethiopia: A systematic literature review, 1990–2019

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Foodborne disease affects millions of people each year, posing a health burden similar to malaria, tuberculosis or HIV. A recent World Bank study estimated the productivity losses alone attributed to unsafe food within Africa at USD 20 billion in 2016, and the cost of treating these illnesses at an additional USD 3.5 billion.

Ethiopia faces multiple food safety challenges due to lack of infrastructure and basic pre-requisites for food safety such as clean water and environment, washing facilities, compounded by limited implementation of food safety regulations, and a lack of incentives for producers to improve food safety.

Improved understanding and evidence of the source, nature and scale of foodborne disease in Ethiopia is needed to inform policy and future research.

To help fill this gap in knowledge, scientists from the International Livestock Research Institute (ILRI), together with partners from the University of Bern, the University of Gondar and Ohio State University, carried out a systematic literature review of publications on foodborne disease occurrence in Ethiopia including hazard presence and impact. The review is published in Frontiers in Sustainable Food Systems (Feb 2023).

Following Cochrane and PRISMA guidelines, the scientists searched PubMed and CAB-Direct online databases for relevant publications between 1990 and 2019. Observational studies and reviews were included. Two reviewers screened titles and abstracts, and retained publications were reviewed in full for quality and data extraction.

In total, 128 articles met the inclusion criteria. Most articles focused on the identification of biological hazards in food. High levels of microbial contamination in different food value chains were often found in the small, ad hoc observational studies that dominated the literature.

Raw milk (22/128, 17.0%) and raw beef (21/128, 16.4%) were the most studied food products. Foodborne parasites were often found at higher rates in food than bacterial and viral pathogens, possibly due to differences in ease of identification. High levels of bacterial contamination on the hands of food handlers were widely reported. There were no reports on the incidence of human foodborne diseases or resulting health and economic impacts.

The findings of the review reflect existing concerns around food safety in Ethiopia. A lack of substantial, coordinated studies with robust methodologies means fundamental gaps remain in our knowledge of foodborne disease in Ethiopia, particularly regarding foodborne disease burden and impact.

“Greater investment in food safety is needed, with enhanced and coordinated research and interventions,” the authors of the review conclude.

Gazu, L., Alonso, S., Mutua, F., Roesel, K., Lindahl, J.F., Amenu, K., Sousa, F.M., Ulrich, P., Guadu, T., Dione, M., Ilboudo, G., Knight-Jones, T. and Grace, D. 2023. Foodborne disease hazards and burden in Ethiopia: A systematic literature review, 1990–2019. Frontiers in Sustainable Food Systems 7: 1058977.

Photo credit: A girl carries a slab of beef in Goro town, Ethiopia, on market day (ILRI/Stevie Mann)

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