Proceedings of the International Conference of Public Health, Vol. 9, Issue. 1, 2024, pp.
1-12
Copyright © 2024 Author(s)
ISSN 2424-6735 online
DOI: https://doi.org/10.17501/24246735.2024.9104
ASSESSING KNOWLEDGE OF TUCK SHOP
OWNERS ON FOOD SAFETY IN RELATION TO
HYGIENE, FOOD POISONING AND
CERTIFICATE OF ACCEPTABILITY IN
VOSLOORUS, CITY OF EKURHULENI, SOUTH
AFRICA
Caine F* and Mokoatle MC
Department of Environmental Health, Faculty of Health Sciences, University of
Johannesburg 2094, South Africa
Abstract: World Health Organization reported on the global burden of food -borne diseases
by stating that the high death rates in regions such as Africa, has the highest burde n of food-
borne diseases per population. The incident that occurred in Soweto and other parts of South
Africa over the safety of food being sold at tuck shops led to community uproar and panic.
The primary objective of the study was to assess the knowledge of tuck shop owners on food
safety in relation to hygiene, food poisoning and Certificate of Acceptability (CoA). A
quantitative cross-sectional study was used. Participants without Certificate of Acceptability
were included. A self-administered questionnaire was used for data collection. The study
population was 324 with a sample size of 100%. Data was captured into Microsoft Excel
and exported to Statistical Package for Social Science (SPSS) for analysis. Tuck shop
owners with primary and secondary education were significantly likely to be knowledgeable
about food safety (OR) 5.88, 95%CI (2.34 -14.63), (OR) 1.72, 95%CI (0.89-3.39).
Participants who were purchasing food products at a retail shop or food warehouse with a
Certificate of Acceptability (n=227; 70.1%) were significantly likely to be knowledgeable
about food safety. The participants that did not know food poisoning were significantly more
likely males in both crude odds ratio12.03 95% CI (2.87 -50.48) and adjusted analysis AOR
8.91, 95% CI (1.89-42.08). About (n=84; 25.9%) of participants did not believe most deaths
are also caused by food poisoning from poor hygiene (OR 8.80 95% CI (2.68 -28.91) and
AOR 8.67, 95%CI (1.83-40.85). The study has shown that tuck shops can be a public health
threat in the community due to lack of knowledge of tuck shop owners on food safety and
food poisoning which could lead to food poisoning outbreaks and subsequently death.
Keywords: food safety, hygiene, public health, tuck shops
Introduction
Food safety includes the handling, transportation, storing and preparing food to prevent contamination
(Ncama et al., 2021). Unsafe food and water that has been exposed to dirt and pathogenic or spoilage
microorganisms, or may even be rotten, which can cause infections and lead to diseases such as diarrhea,
meningitis etc. (Alsultan et al., 2023). Food Agricultural Organisation, (2019) emphasized the
importance of food safety to public health. Food-borne illnesses (FBDs) are inextricably linked to
outbreaks and pose a threat to the security of global public health, and are a global issue (Azanaw,
Gebrehiwot and Dagne, 2019). Food safety is a major concern for consumers, food industries, and food
*Corresponding Author’s Email: [email protected]
Proceedings of the International Conference of Public Health, Vol.9, Issue.1,2024, pp1-12
control officials in both developed and developing countries (Mkhungo, Oyedeji and Ijabadeniyi, 2018).
In countries where natural disasters, political unrest, food shortages, and other pressing issues take
centre stage on government and media agendas, food safety is frequently disregarded (Abegaz, 2022a).
Akabanda et al. (2017) Ghanaian food handlers were frequently blamed for several food-borne disease
outbreaks, about 97% of cases of food poisoning that have been documented were caused by people
working in the catering industry mishandling food. Food safety and security regulations must be
followed, and the ability to recognize and track harmful bacteria is a prerequisite for both food safety
and food security (Food poisoning hazards and their consequences over food safety, 2020). Human
outbreaks of foodborne illness are widespread in South Africa but rarely reported (Ntshoe et al., 2021).
The incident that occurred in Soweto and other areas of the country over safety of food provided at tuck
shops was emphasized Damane's (2018). The WHO in 2015 reported on the global burden of foodborne
diseases for the first time by estimating the disease burden caused by 31 foodborne agents (bacteria,
viruses, parasites, toxins and chemicals) between years 2007-2015 at global and regional level (WHO,
2019).The disease burden caused by foodborne agents could be due to the poor state of food safety and
general hygiene in those countries with high deaths rate such as African region(Tasneem Maher Al-
Jaberi et al., 2023). To prevent food-borne illness, it is necessary to understand how food becomes
unsafe and what proactive measures can be taken to ensure food safety (Abegaz, 2022b). The inadequate
food safety knowledge and skills of food handlers can result in unsafe food handling practices and cross-
contamination in food service establishments Tef fo and Tabit, (2020). some food handlers in many food
service establishments often lack basic food safety knowledge when it comes to food hygiene and the
prevention of cross-contamination Chellaiyan et al., (2018). middle school students have a wide range
of understanding about handling food safely. However, this knowledge is at the knowledge (recall) level
with inadequate understanding of why safe food handling is crucial Byrd -Bredbenner et al. (2016).
Onyeaka, Dassalegn Daraje Jalata and Solomon Abate Mekonnen, (2023) concluded that the results of
their study highlight the importance of consumer education and regulatory compliance in ensuring food
safety, providing insightful information for those involved in the food sector. The primary objective of
the study was to assess the knowledge of tuck shop owners on food safety in relation to hygiene, food
poisoning and Certificate of Acceptability.
Methods
Study design and population.
The study included Tuck shop owners within the Vosloorus area. According to City of Ekurhuleni,
Vosloorus Environmental health statistics 2019, there were 324 Tuck shop owners (tuck shops) in
Vosloorus (City of Ekurhuleni, 2019). Tuck shop owners with no Certificate of Acceptability (CoA)
were targeted because they were not certified in terms of R638 regulations governing general hygiene
requirements for food premises, the transport of food and related matters, under foodstuffs, Cosmetics
and Disinfectants Act 54 of 1972 (regulations governing general hygiene requirements for food
premises, the transport of food and related matters, n.d.). Tuck shop owners who were willing to
participate in the study with tuck shops that are operational were included in the study.
Tuck shop owners that were not within the Vosloorus area in the City of Ekurhuleni were excluded.
Moreover, tuck shops with valid Certificate of Acceptability in terms of regulation 638 under
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Caine and Mokoatle, Assessing Knowledge of Tuck Shop Owners on Food Safety in………….
Foodstuffs, Cosmetics and Disinfectants act 54 of 1972 were excluded from the study. Tuck shop
owners who were not willing to participate were excluded in the study as well as those under the age of
18 years. The research study used a cross-sectional study design and one of a cross-sectional study
advantages is that it is frequently employed to quantify the frequency of health outcomes, comprehend
health factors, and characterize demographic characteristics. it does not follow individuals over time
and Individual change cannot be examined using them as in a cohort study (Wang and Cheng, 2020).
The Tuck shop owners of City of Ekurhuleni, Vosloorus were used as dependent variables in the
research study. The researcher was interested in the influence and effects of their knowledge concerning
food safety. Tuck shop owners of City of Ekurhuleni, Vosloorus were being assessed based on their
knowledge of food safety in relation to hygiene, food poisoning and Certificate of Acceptability.
Dependent variables for this research study consisted of Tuck shop owners (tuck shop/Spaza shop
owners) who own such businesses within the City of Ekurhuleni, Vosloorus.
Data Collection
Data was collected through self -administered questionnaires from respondents. Response rate was
100% (324 participants) as well as sample size. The formulation of questions and answer options was
made simple, concise, and extremely specific, ensuring that no ambiguities. Simple terms were used to
ensure the questionnaire is suitable for the target population. The sequence of the flow of questions was
carefully planned to ensure logic flow with basic demographic information first follo wed by the rest.
Potential participants were approached by the researcher at various tuck shops in the study site and were
issued with the information letter containing the details of the study. Those agreed to participate were
requested to give consent for participation and were issued with the questionnaires. Participants were
given time to complete the questionnaire in their own comfort and pace and the researcher followed up
after three days to collect the completed questionnaires. If not completed, a second chance was given,
and follow-up was done. A pilot study was carried out on 10% of the sample size to check if the
questionnaires measured what was supposed to be measured. Reliability was also tested in terms of
checking acceptability and consistency in the flow of responses. If the characteristics in the same group
were measured repeatedly higher or repeatedly lower than the real valued that meant the measurement
instrument lacked validity. All data entry for computer analysis was double-punched and verified. This
means that researcher entered the data twice. To check the degree to which a questionnaire can be
depended upon to secure consistent results upon repeated application. Validity provided evidence about
how well scores on the new measure correlate with other measures of the same construct or similar
underlying constructs that theoretically should be related.
Data Analysis
The data was entered into the statistical package for analysis, it was cleaned before analysis to assess
accuracy. That involved editing and correcting unusual figures in coding. Descriptive statistical analysis
was used to identify frequencies and percentages to answer all questions in the questionnaire. EPINFO
7.2 was used to calculate crude odds ratios as it visualizes the d ata. SPSS version 28 was used to
calculate the adjusted odds ratios using multivariate and logistic regression to establish the probability
or likelihood of factors associated with knowledge, attitude, and beliefs when it comes to food safety.
The statistical significance of relationship among variables were determined using the confidence
intervals and data is presented in tables and figures.
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Proceedings of the International Conference of Public Health, Vol.9, Issue.1,2024, pp1-12
Ethical Considerations
Permission to conduct research was received from the University of Johannesburg Higher Degree
committee (Appendix 1), Research Ethics committee (Appendix 2) and Department of Health,
Ekurhuleni Health District Research Forum. All participants were informed about the aim and
objectives of the research and permission was requested from Tuck shop owners to participate in the
study by signing an informed consent.
Results
Socio-Demographic Characteristics of Study Participants
As shown in table 1 the overall number of participants (n=324,100%) out of the total number of
participants males (n=262, 80.9%) and females (n=62, 19.1%). Among these participants there were
more males aged between 31-40 years (n=116, 81.7%) followed by females (n=26, 18.3%). Most males
(n=119, 78.8%) had secondary education and (n=32, 21.2%) were females. Most single participants
were males (n=204, 86.8%) with only (n=31, 13.2) of females. Among ethnicity category South
Africans males had (n=109, 64.9%) participants with only (n=59, 35.1%) of South African female
participants. Among nationalities most participants were South African males (n=111, 64.9%) and
South African females were (n=60, 35.1%).
Table 1: Socio-Demographic Characteristics of Tuck Shop Owners Stratified by Genders
Total Males Females
Characteristics n % n % n %
Total 324 100% 262 80.9% 62 19.1%
Age
≤30 years 92 28.4% 76 82.6% 16 17.4%
31 – 40 years 142 43.8% 116 81.7% 26 18.3%
41– 67 years 90 27.8% 70 77.8% 20 22.2%
Education
Primary 110 34.0% 102 92.7% 8 7.3%
Secondary 151 46.6% 119 78.8% 32 21.2%
Tertiary 57 17.6% 39 68.4% 18 31.6%
Other 6 1.9% 2 33.3% 4 66.7%
Marital Status
Single 235 72.5% 204 86.8% 31 13.2%
Married 46 14.2% 29 63.0% 17 37.0%
Separated/ Widowed/ 43 13.3% 29 67.4% 14 32.6%
Divorced
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Caine and Mokoatle, Assessing Knowledge of Tuck Shop Owners on Food Safety in………….
Ethnicity
South African* 168 51.9% 109 64.9% 59 35.1%
Pakistani 109 33.6% 107 98.2% 2 1.8%
Bangladeshi and Indian 26 8.0% 26 100% 0 0.0%
(1)
Other ** 21 6.5% 20 95.2% 1 4.8%
Nationality
South African 171 52.8% 111 64.9% 60 35.1
Bangladeshi 25 7.7% 25 100% 0 0.0%
Pakistani 109 33.6% 107 98.2% 2 1.8%
Other *** 19 5.9% 19 100% 0 0.0%
Distribution of Research study Participants by whether they knew a Certificate of Acceptability (CoA).
Majority of participants (n=240: 74.1%) believed that most deaths are also caused by food poisoning
from poor hygiene of which the majority were males (n=181: 75.1%), however, about half of the study
participants (n= 166: 51.2%) did not know if there was a relationship between food hygiene and food
poisoning of which (n= 145: 87.3%) were males (see table 2).
Table 2: Distribution of Research Study Participants by whether they knew or have heard about a
Certificate of Acceptability (CoA)
Total Males Females
Characteristics n % n % n %
Total 324 100% 262 80.9% 62 19.1%
Where do you purchase your foodstuffs/stock?
Retail shop 60 18.5% 41 68.3% 19 31.7%
Food warehouse 225 69.4% 187 83.1% 38 16.9%
Other 39 12.0% 34 87.2% 5 16.9%
Do you know a Certificate of Acceptability (CoA) or have you heard about it
Yes 173 53.4% 141 82.5% 30 17.5%
No 151 46.6% 120 80.0% 30 20.0%
Do you purchase foodstuffs/stock at a retail shop or food warehouse with a CoA?
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Proceedings of the International Conference of Public Health, Vol.9, Issue.1,2024, pp1-12
Yes 227 70.1% 174 76.7% 53 23.3%
No 97 29.9% 88 90.7% 9 9.3%
Distribution of Crude and Adjusted Odds Rations for Hygiene and Food Poisoning of Research Study
Participants
About 173(53.4%) of participants knew or have heard about Certificate of Acceptability and Females
were (n=30, 17.5%) compared to Males(n=141;82.5%). Most participants (n= 227;70.1%) purchased
their foodstuffs/stock where there was a Certificate of Acceptability (see table 3).
Table 3: Crude and Adjusted Odds Rations for Hygiene and Food Poisoning
Characteristics Crude Odds 95% CI Crude Odds 95% CI
ratios ratios
Do you believe that most deaths are also caused by food poisoning from poor hygiene?
Yes Reference Reference Reference Reference
No 8.80 2.68 – 28.91 8.67 1.83 – 40.85
Do you know what food hygiene is?
Yes Reference Reference Reference Reference
No 7.30 0.97 - 54.72 2.79 0.33 – 23.31
Do you know what food poisoning is?
Yes Reference Reference Reference Reference
No 12.03 2.87-50.48 8.91 1.89 – 42.08
Is there a relationship between food hygiene and food poisoning?
Yes Reference Reference Reference Reference
No 2.42 1.36-4.32 1.88 0.97 – 3.67
Do you believe that proper hygiene can prevent most food poisoning outbreaks?
Yes Reference Reference Reference Reference
No 2.05 0.99 - 4.22 Undefined undefined
“The cleaner the environment the safer the food” do you believe in this saying?
Yes Reference Reference Reference Reference
No 13.20 1.78 - 97.68 Undefined undefined
* CI is the 95% Confidence Intervals
** Adjusted for age, gender, education, and marital status
Distribution of Food Poisoning of Study Participants by Gender
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Caine and Mokoatle, Assessing Knowledge of Tuck Shop Owners on Food Safety in………….
Most participants (n=247: 76.2%) knew what food poisoning was, Males (n=187:75.7%) and Females
(n=60;24.3).
Tuck shop owners with primary and secondary education were significantly more likely to be males
Odds Ratios (OR) 5.88, 95%CI (2.34-14.63), OR 1.72, 95%CI (0.89-3.39), respectively, but the
association did not hold in adjusted analysis. Tuck shop owners with marital status married,
separated/widowed/divorced were less likely to be males in both crude and adjusted analysis adjusted
odds ratios OR 0.26, 95% CI (0.13-0.53) and (AOR) 0.31, 95%CI (0.13-0.73). For the separated OR
0.31, 95%CI (0.15-0.67) and AOR 0.39, 95%CI (0.16-0.69) respectively. Tuck shop owners from
Pakistani, Bangladeshi and Other ethnicity was significantly more likely to be males in the crude
analysis only OR 2.89, 95% CI (1.63-5.14); OR 14.07, 95% CI (1.86-106.33); and OR 10.83, 95% CI
(1.42-82.69), respectively. And for Other, in adjusted analysis AOR 11.24, 95%CI (1.35 -93.04). For
nationality, tuck shop owners of Bangladesh, Pakistan, and other nationalities were significantly more
likely to be males OR13.51 95% CI (1.79-102.21); OR 28.92, 95% CI (6.10-121.28); and OR 10.27,
95% CI (1.34-78.61), respectively. For Pakistan nationality the estimates were significant in adjusted
AOR 29.83, 95%CI (5.63-134.05).
Discussion
Tuck shop owners with education were more likely to be knowledgeable about food safety. The study
further compared the level of education according to gender of participants and found that most of
participants with primary education were males (92.7%) followed by female participants (7.3%). About
(78.8%) of participants were males with secondary education followed by female participants with
(21.2%) who also had secondary education. This finding was contrary to the study by (Mshelia et al.,
2022) which found that postgraduates at public university in Selangor, Malaysia had poor knowledge
on food safety. However, Ozilgen, (2010) stated that the more educated the person is, the more he or
she is empowered with knowledge. (Ncube et al., 2019) revealed that higher educated food handlers
were frequently observed to follow safe food handling procedures more often than lesser educated ones.
Fortune et al, 2017 emphasized that Ghanaian institutional food ha ndlers possessed adequate
understanding of cleaning, sanitation practices, general and personal hygiene, and food safety.
However, they further stated that ongoing food safety training and encouragement for food handlers
from diverse backgrounds with a focus on those with less education would be a beneficial addition to
other initiatives aimed at improving Ghana's food safety framework.
The study also revealed that Tuck shop owners with marital status; married, separated/ widow/divorced
were less likely to be knowledgeable about food safety. However, this finding is arguable based on the
lack of scientific proof that links food safety and marital status; hence a further study could be necessary
to find the direct link between marital status and food safety. The study further compared the gender of
participants according to their marital status and found that most married participants were males (n=29;
63, 0%) with only few female participants (n=17; 37.0%). The higher proportion of participants who
were either separated/widowed/ divorced were males (n=29; 67, 4%) followed by female participants
with (n=14; 32, 6%). Participants with Pakistani, Bangladeshi and Indian nationality were more likely
to be knowledgeable about food safety in adjusted odds ratios. This finding was inconsistent with what
was reported by (Wan Nawawi et al., 2022), in their study which assessed the level of knowledge,
attitude, and practices in relation to food safety among food truck vendors and the respondents were
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Proceedings of the International Conference of Public Health, Vol.9, Issue.1,2024, pp1-12
predominantly Malaysians with few other nationalities and had at least secondary education and work
experience in food industry. The study found that they had fair knowledge, a positive attitude, and good
practices relating to food safety. Participants with Bangladesh, Pakistan and other nationalities were
more likely to be knowledgeable about food safety in adjusted odds ratios. Bangladeshi nationalities
were only males (n=25; 100%). The higher proportion of participants with Pakistani nationality in the
study were males (n=107; 98, 2%) with only few female participants (n=2; 1, 8%).
Tuck shop owners who did not know a Certificate of Acceptability or have not heard about it were more
likely to be less knowledgeable about food safety. The finding related to the study inclusion criteria that
only food premises without Certificate of Acceptability (CoA) were included because those with
Certificate of Acceptability were given health education in relation to food safety and food premises
requirements before Certificates of Acceptability were issued to them and were regarded as
knowledgeable. The study further showed a higher proportion of male participants with (n=120; 80,
0%) who did not know or have not heard about Certificate of Acceptability compared with female
participants (n=30; 20, 0%). This finding correlated with other studies by Ismail, et al,(2016) which
stated that studies conducted by Food Agriculture Organization (1995) recorded that poor knowledge
led to poor practices in food handling base on the assessment of microbial contamination of food sold
by the mobile food handlers. Tuck shop owners who did not think contaminated food can make a person
sick were significantly more likely to be less knowledgeable about food safety. The study further
revealed that a smaller number of female participants (n=2; 3, 4%) who shared the same sentiment
compared with high number of male participants (n=57; 96, 6%). Both significant findings related to
lack of knowledge about food safety. (Nguyen et al., 2018) highlighted the necessity of improving
consumers' defence mechanisms, the ability of local authorities to monitor and inspect the food
processing process, and the need for consumers to be aware of the environmental standards that food
facilities must meet. The report went on to say that both food processors and patrons must have enough
awareness of cleanliness and safety regulations to prevent foodborne illnesses in food facilities.
Tuck shop owners who said there was no relationship between food hygiene and food poisoning were
significantly more likely to be less knowledgeable about food safety with most male participants
(n=145; 87, 3) and least females ((n=21; 12, 7%). “When you know better, you do better,” the study
findings were a true reflection of lack of knowledge by Tuck shop owners on food safety. Khuluse, and
Deen, (2020) revealed in their study that food vendors lack the knowledge of proper hygiene and safety
which relates to any informal food premises. Nyawo, Kesa and Onyenweaku, (2021) found that one of
the reasons food handlers disregarded food safety and hygiene regulations was a lack of education and
awareness. The results also showed that to stop the transmission of pathogens (cross -contamination)
during food preparation and avoid foodborne illnesses, food workers should be required to complete
training. Manafe, Gordon and Ncube, (2023) further emphasized the importance of education by stating
that most foodborne illness cases have a domestic origin.
The study revealed that Tuck shop owners who did not believe that most deaths are also caused by food
poisoning from poor hygiene were significantly more likely to be less knowledgeable about food safety.
The study further showed that most male participants (n=81; 96, 4%) did not believe that most deaths
are also caused by food poisoning from poor hygiene compared with the number of female participants
(n=3;3,6%). The Tuck shop owners who did not know about food poisoning were significantly more
likely to be less knowledgeable about food safety. Most (n=75; 97, 4%) of male participants did not
40
Caine and Mokoatle, Assessing Knowledge of Tuck Shop Owners on Food Safety in………….
know food poisoning compared with female participants (n=2; 2, 6%). Tuck shop owners who said
there is no relationship between food hygiene and food poisoning were significantly more likely to be
less knowledgeable about food safety with most male participants (n=145; 87, 3) and female
participants (n=21; 12, 7%) who share the same sentiment.
Study Limitations
Lack of previous studies, both national and international, on the study topic made it a challenging to get
a relevant literature review. Language barrier was one of the limitations of the study which in turn
impacted on the data collection. Not enough data was one of the most limitations in the study.
Participants sometimes were busy serving their clients. The element of crime in the study area made the
participants sceptical of allowing a researcher to enter their food premises. The study was limited to
one area within the Ekurhuleni metropolitan municipality and future studies can be expanded to more
areas and wider municipalities in South Africa.
Abbreviations
FBD: Food-borne diseases; SPSS: Statistical package for social sciences; CoA: Certificate of
Acceptability; WHO: World health organization; OR: Odds ratio; AOR: Adjusted odds ratio; CI:
Confidence interval.
Acknowledgements
Dr M. C. Mokoatle, Prof. Shinga Feresu, The City of Ekurhuleni. The regulatory research bodies that
gave permission for the study, including the Ekurhuleni Health Research Committee, The University of
Johannesburg Higher Degrees Committee, and The University of Johannesburg Academics Ethics
Committee. All the who participated in the study. Ms N. Fikeni (Senior Manager for Environmental
Health Services at King Cetshwayo District Municipality) and Terence Munyai (Senior Environmental
Health Practitioner at the City of Ekurhuleni).
Author’s Contributions
The Author wrote a research proposal for approval, data collection tool, collected data, entered data into
Microsoft Excel, cleaned data and exported it into SPSS software, entered data into Epi-info, analyse
and interpreted the data, and wrote the paper with the assistance of Dr M. C. Mokoatle.
Funding Information
The Author of the study has received no funding for the study. The Author funded the study.
Availability of Data and Materials
Data and materials are available upon request.
Consent to Publication
The manuscript does not contain any confidential information.
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Proceedings of the International Conference of Public Health, Vol.9, Issue.1,2024, pp1-12
Competing Interest
The Author declares that they have no competing interests.
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