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

Objective(s):
To summarize literature on foodborne hazards and their associated burden in Ethiopia, identify
research gaps and intervention targets.
Materials and methods:
A systematic literature review was performed according to Cochrane and PRISMA guidelines.
Searches were performed on PubMed and CAB Direct for relevant publications between 1990 and
2019 (inclusive). Observational studies, secondary data analyses, reviews and grey literature were
included. Titles and abstracts were screened, and selected publications reviewed in full for quality
and data extraction. A metanalysis was not conducted as studies were varied in focus with few
similar studies estimating the same parameter.
Results:
In total 142 articles met the inclusion criteria. Most studies focused on identification and prevalence
of biological and chemical hazards in food. High levels of microbial contamination in different food
value chains were often found by the typically small, ad hoc, observational studies. Dairy products,
beef, poultry, and eggs were the most commonly studied food products. Raw beef and raw milk
were the products reporting higher levels of pathogen contamination. Presence of Listeria
monocytogenes, a serious but often overlooked foodborne pathogen, was reported in various foods.
Several important value chains were less frequently studied including vegetables, fruits, crops, fish,
sheep, goats, and camel. There were few reports of incidence of human FBD or resulting health and
economic impacts. High levels of bacterial contamination on the hands of food processors were
widely reported. Foodborne parasites were often found at higher prevalences in food than bacterial
and viral pathogens, possibly due to differences in ease of identification.
Conclusion:
There are fundamental gaps in the knowledge of food hazards in Ethiopia, particularly regarding
FBD incidence and impact. Furthermore, important value chains and pathogens have been
neglected. Greater investment in food safety is needed, with enhanced and coordinated research.