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Effect of Typhoid Fever Education on Food and Water Hygiene Practices among Food Vendors in Nigeria

Abstract

Typhoid fever remains an important public health concern in settings where access to safe drinking water, adequate sanitation, and proper food hygiene is limited. The disease is primarily associated with infection by Salmonella Typhi and can be transmitted through ingestion of food or water contaminated with human faecal material. Food vendors play an important role in public health because inadequate food preparation, handling, storage, or water hygiene can contribute to the contamination and transmission of enteric pathogens. Food and water hygiene practices include proper handwashing, use of safe water, appropriate food storage and preparation, protection of food from contamination, proper cleaning of utensils and surfaces, safe disposal of waste, and avoidance of practices that may facilitate foodborne disease transmission. Typhoid fever education provides food vendors with information about the causes, transmission, symptoms, prevention, and public health consequences of typhoid fever, as well as appropriate food and water hygiene measures. In Nigeria, inadequate hygiene knowledge, limited access to safe water, poor sanitation infrastructure, insufficient food safety training, and economic and environmental constraints may negatively affect hygiene practices among food vendors. Effective typhoid fever education may improve vendors' understanding of disease transmission and encourage safer food and water handling practices. Against this background, this study investigates the effect of typhoid fever education on food and water hygiene practices among food vendors in Nigeria. The study is anchored on the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding food vendors' decisions to adopt appropriate hygiene practices. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping health and safety behaviours. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from typhoid fever education may influence food and water hygiene practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how typhoid fever education may influence hygiene practices among food vendors in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from food vendors operating in selected markets, streets, schools, transport terminals, and other food vending locations in Nigeria using a structured interviewer-administered questionnaire and, where feasible, a food hygiene observation checklist. A multistage sampling technique will be employed to select states, local government areas, communities, vending locations, and eligible food vendors. Where feasible, selected vending locations or participants will be assigned to intervention and comparison groups. Food vendors in the intervention group will receive structured typhoid fever and food safety education covering disease transmission, safe water use, hand hygiene, food preparation, food storage, utensil cleaning, protection of prepared food, waste disposal, environmental sanitation, and appropriate practices for preventing contamination. Food and water hygiene practices will be assessed using indicators such as handwashing practices, use and storage of water, food preparation and storage, utensil and surface cleanliness, protection of food from contamination, waste disposal, and environmental hygiene. Where feasible, self-reported practices will be complemented by direct observation of food vending environments. Descriptive statistics will be used to summarize vendors' sociodemographic and occupational characteristics, exposure to typhoid fever education, and hygiene practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be employed to determine the effect of typhoid fever education on food and water hygiene practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, and robustness of the findings. The study anticipates that typhoid fever education will have a significant positive effect on food and water hygiene practices among food vendors in Nigeria. Vendors exposed to structured typhoid fever education are expected to demonstrate improved knowledge of disease transmission and greater adherence to appropriate hygiene practices. Education may encourage proper hand hygiene, safer water handling, appropriate food preparation and storage, improved utensil and surface cleaning, better protection of food from contamination, and appropriate waste disposal. However, education alone may not guarantee consistent hygiene practices because vendors may face barriers such as inadequate access to potable water, poor sanitation facilities, limited waste-disposal services, overcrowded vending environments, cost constraints, lack of storage facilities, and weak enforcement of food safety regulations. Consequently, typhoid fever education is expected to be most effective when supported by adequate water and sanitation infrastructure, regular food safety inspections, accessible hygiene facilities, effective waste management, and appropriate regulatory enforcement. This study is expected to contribute to the literature on food safety, water and sanitation, infectious disease prevention, health education, environmental health, and public health in Nigeria by providing empirical evidence on the effect of typhoid fever education on food and water hygiene practices among food vendors. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention (NCDC), state ministries of health, local government health authorities, environmental health departments, food safety regulatory agencies, market associations, food vendors, public health practitioners, and policymakers regarding strategies for preventing food- and water-borne diseases. The study will also provide evidence-based recommendations for strengthening food vendor health education, improving access to safe water and sanitation facilities, promoting regular food safety training, strengthening environmental health inspections, improving waste management around vending locations, and enforcing appropriate food hygiene standards across Nigeria.

Keywords: Typhoid fever education, food hygiene practices, water hygiene practices, food vendors, typhoid fever prevention, food safety, water safety, environmental health, health education, infectious disease prevention, public health, Nigeria.