Diarrhoea and water-borne diseases are leading causes of mortality in developing countries. To understand the socio-cultural factors impacting on water safety, we documented knowledge, attitudes and practices of water handling and usage, sanitation and defecation in rural Tamilnadu, India, using questionnaires and focus group discussions, in a village divided into an upper caste Main village and a lower caste Harijan colony. Our survey showed that all households stored drinking water in wide-mouthed containers. The quantity of water supplied was less in the Harijan colony, than in the Main village (P<0.001). Residents did not associate unsafe water with diarrhoea, attributing it to 'heat', spicy food, ingesting hair, mud or mosquitoes. Among 97 households interviewed, 30 (30.9%) had toilets but only 25 (83.3%) used them. Seventy-two (74.2%) of respondents defecated in fields, and there was no stigma associated with this traditional practice. Hand washing with soap after defecation and before meals was common only in children under 15 years (86.4%). After adjusting for other factors, perception of quantity of water received (P<0.001), stated causation of diarrhoea (P=0.02) and low socio-economic status (P<0.001) were significantly different between the Main village and the Harijan colony. Traditional practices may pose a significant challenge to programmes aimed at toilet usage and better sanitation.

Foodborne diseases are one of the health hazards and causes of morbidity and mortality in developing countries. In India there are no systematic studies to understand the types of foods involved and the etiological agent causing the disease. Therefore, a pilot study was proposed to investigate the food poisoning cases, undertaken by the Ronald Ross Institute of Tropical Diseases, which is a referral hospital for foodborne diseases in Hyderabad. Food and stool/rectal swabs of the patients affected were collected for microbiological examination. Odds ratio and 95% confidence interval were used to express the statistical significance of the differences. Epidemiological, environmental, and laboratory components indicated that Staphylococcus aureus was the etiological agent in most of the cases and in one case Salmonella spp. were the main cause of food poisoning. This study indicated the need to take up foodborne disease surveillance under the Indian context and to identify the common high-risk food commodities for microbial contamination and identification.

Purpose The purpose of this paper is to identify and prioritize the key food safety practices among street food handlers that lead to microbial contamination in selected street foods of Hyderabad, India. These key food safety practices will help develop and design tailor-made training material for street food vendors in future. Design/methodology/approach It is a cross-sectional study conducted in south Indian city of Hyderabad. Stratified random sampling method was employed. A total of 463 samples of street foods were collected from five zones of Hyderabad. They included 163 salad toppings, 150 fresh fruit juices and 150 panipuri samples. Identification and enumeration of foodborne pathogens and indicator organisms (S. aureus, E. coli, Salmonella spp., Shigella spp., Bacillus cereus, Yersinia spp.) were performed as described by USFDA-BAM. Information on food safety knowledge and handling practices from street vendors were collected using a structured questionnaire. Associations between hygiene practices and bacterial pathogens were done using ANOVA. Risk estimation of food safety practices was assessed by calculating odds ratio. Findings Microbiological analysis indicated that a large number of carrot (98.1 percent) and onion (75.5 percent) samples were contaminated with E. coli. Peeled and cut fruits left uncovered have 13.4 times risk (OR: 2.40-74.8) of E. coli contamination compared to the covered ones. Panipuri samples picked from the vendors who did not have soap at the vending unit had significantly (p<0.001) higher contamination of fecal coliforms than those who had. Originality/value This study is the first of its kind in the study area.

A study has been done to analyse the microbiological quality of salads served along with street foods of Hyderabad. A total of 163 salad samples, 53 of carrot and 110 of onion samples, were collected from four different zones of Hyderabad. About 74% and 56% had Staphylococcus aureus in carrots and onions, respectively. Fifty-eight percent of carrots and forty-five percent of onions samples contained Salmonella, 68% of carrots and 24% of onions had Yersinia. HACCP study was carried out with 6 street food vendors to identify the source of Salmonella contamination in salads. Food handlers were found to be responsible for Salmonella contamination in salads. The present study revealed the potential hazards of street vended salad vegetables, considering the handling practice usually carried out by vendors. Ninety-eight percent of the vendors did not wash the vegetables before processing and serving while about 56.6% of the vendors did not peel the vegetables. Majority of street vendors' nails were uncut. A significant difference (P < 0.01) was observed in Yersinia spp. and Salmonella spp. in wet-dirty chopping board when compared to clean-dry chopping board. A significant difference (P < 0.05) of Staphylococcus spp. was observed when the status of cleaning cloth was neat/untidy.