Sains Malaysiana 50(4)(2021): 1027-1036

http://doi.org/10.17576/jsm-2021-5004-13

Food Poisoning Outbreaks among Schoolchildren in Terengganu and their Associated Factors

(Wabak Keracunan Makanan dalam Kalangan Pelajar Sekolah di Terengganu dan Faktor Penyumbangnya)

NUR BAIZURA AINI ABDULLAH & AHMAD FILZA ISMAIL*

Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan Darul Naim, Malaysia

Diserahkan: 24 Disember 2019/Diterima: 21 September 2020

ABSTRACT  

Food poisoning is a public health problem in Malaysia and among the top five communicable diseases in Malaysia. This study aimed to determine the proportion of food poisoning cases involving schoolchildren in Terengganu in 2016 and their associated factors. This was a cross-sectional study using secondary data collected from 21 food poisoning outbreaks among schoolchildren in Terengganu in 2016. The proportion of food poisoning outbreaks involving schoolchildren in Terengganu in 2016 was 63.6%. Ministry of Education (MOE) school had contributed to 95.3% of outbreak cases, 81% occurred at secondary school and 57.1% involved school located in urban district. Poultry (61.9%) was the most common food vehicle, and Salmonella spp. (52.4%) was the most common microbial etiological agent. Urban district schools had the adjusted odds (aOR=1.803; 95% CI: 1.435,2.267; p < 0.001) compared with rural district schools. Non-MOE schoolchildren were more likely to be involved in school food poisoning (aOR= 4.439; 95% CI: 2.690,7.177; p <0.001) compared with MOE schoolchildren. Moreover, egg consumption was 4.6 times (aOR=4.627; 95% CI: 1.779,12.035; p=0.002) more likely to be associated with school food poisoning outbreaks in Terengganu in 2016 compared with rice consumption. Cross-contamination (aOR=0.445; 95% CI: 0.445,0.231; p=0.015) was less likely to be linked to school food poisoning compared with inadequate cooking and reheating. Food poisoning among schoolchildren in Terengganu has been associated with non-modifiable factors, such as school district location, and modifiable factors, such as food vehicles and critical control points. Health education on food safety, food handling, strict hygiene practice and clean canteen environment need to be strengthened.

Keywords: Foodborne disease; food poisoning outbreak; schoolchildren

ABSTRAK

Keracunan makanan adalah salah satu masalah kesihatan awam dan antara lima penyakit berjangkit utama di Malaysia. Kajian ini adalah untuk menentukan perkadaran kes wabak keracunan makanan yang melibatkan pelajar sekolah di Terengganu pada tahun 2016 dan faktor yang berkaitan dengannya. Kajian ini dilakukan dengan kaedah hirisan lintang menggunakan data sekunder kejadian wabak keracunan makanan yang melibatkan pelajar sekolah di Terengganu pada tahun 2016. Perkadaran kejadian wabak keracunan makanan yang melibatkan pelajar sekolah di Terengganu tahun 2016 adalah 63.6%. Sekolah di bawah kelolaan Kementerian Pelajaran Malaysia (KPM) menyumbang kepada 95.3% kes keracunan makanan dengan sekolah menengah menyumbang kepada 81% kes dan 57.1% berlaku di sekolah yang terletak di kawasan bandar. Ayam (61.9%) adalah jenis makanan yang tertinggi menyumbang kepada kejadian wabak keracunan makanan di sekolah dan Salmonella spp. (52.4%) adalah agen etiologi mikrob yang paling kerap dijumpai. Sekolah yang terletak di kawasan bandar (aOR=1.803; 95% CI: 1.435, 2.267; p <0.001) dan pelajar sekolah di bawah kelolaan bukan KPM (aOR= 4.394; 95% CI: 2.690,7.177; p<0.001) mempunyai risiko lebih tinggi untuk mengalami wabak keracunan makanan berbanding dengan sekolah di bawah KPM. Di samping itu, pelajar yang memakan telur adalah 4.6 kali (aOR: 4.627; 95% CI: 1.779, 12.035; p=0.002) lebih berisiko untuk terlibat dengan wabak keracunan makanan di sekolah jika dibandingkan dengan nasi atau bijirin. Pencemaran silang (aOR = 0.445; 95% CI: 0.445.0.231; p = 0.015) mempunyai risiko yang lebih rendah berbanding risiko memakan makanan yang tidak dimasak sepenuhnya atau suhu pemanasan makanan yang tidak mencukupi. Keracunan makanan dalam kalangan pelajar sekolah di Terengganu adalah berkaitan dengan faktor seperti lokasi sekolah, jenis makanan dan titik kawalan kritikal semasa penyediaan makanan. Pendidikan kesihatan perlu diperkukuhkan dalam aspek keselamatan makanan, pengendalian makanan, amalan kebersihan yang sempurna dan persekitaran kantin yang bersih semasa penyediaan makanan.

Kata kunci: Pelajar sekolah; penyakit bawaan makanan; wabak keracunan makanan

RUJUKAN

Ababio, P.F., Taylor, K.D.A., Daramola, B.A. & Swainson, M. 2016. Food law compliance in developed and developing countries: Comparing school kitchens in Lincolnshire-UK and Ashanti region of Ghana. Food Control 68: 167-173.

Abdul-Mutalib, N., Syafinaz, A., Sakai, K. & Shirai, Y. 2015. An overview of foodborne illness and food safety in Malaysia. International Food Research Journal 22(3): 896-901.

Ali, N. & Abdullah, M.A. 2012. The food consumption and eating behaviour of Malaysian urbanites: Issues and concerns. Geografia-Malaysian Journal of Society and Space 8(6): 157-165.

Carrasco, E., Morales-Rueda, A. & García-Gimeno, R.M. 2012. Cross-contamination and recontamination by Salmonella in foods: A review. Food Research International 45(2): 545-556.

Daniels, N.A., Mackinnon, L., Rowe, S.M., Bean, N.H., Griffin, P.M. & Mead, P.S. 2002. Foodborne disease outbreaks in United States schools. The Pediatric Infectious Disease Journal 21(7): 623-628.

de Oliveira, A.B.A., da Cunha, D.T., Stedefeldt, E., Capalonga, R., Tondo, E.C. & Cardoso, M.R.I. 2014. Hygiene and good practices in school meal services: Organic matter on surfaces, microorganisms and health risks. Food Control 40: 120-126.

Garayoa, R., Cordoba, M., Garcia-Jalon, I., Sanchez-Villegas, A. & Vitas, A.I. 2005. Relationship between consumer food safety knowledge and reported behavior among students from health sciences in one region of Spain. Journal of Food Protection 68(12): 2631-2636.

Harun, N., Badgujar, V.B., Tan, Y., Othman, N., Ramli, N., Shahabudin, S. & Zainudin, N. 2015. Poultry chicken eggs: A safe, secure and bacteria free regime in Malaysia. Journal of Health, Population, and Nutrition 29(2): 103.

IPH. 2008.  Load of illness. The Third National Health and Morbidity Survey (NHMS III) Malaysia: Ministry of Health. pp. 3-49.

Jeffree, S.M. & Mihat, O. 2016. Waterborne food poisoning outbreak of Bacillus cereus in primary school Sabah East Malaysia. Journal of Advanced Research in Medicine 3(2&3): 22-29.

Kar, K., Pradhan, S. & Samal, B.P. 2018. Morbidity pattern of school children: A study conducted in the urban field practice area of a tertiary health care centre of Odisha, India.  International Journal of Research in Medical Sciences 6(7): 2489-2494. (Kar, 2018 #138)

Linscott, A.J. 2011. Food-borne illnesses. Clinical Microbiology Newsletter 33(6): 41-45.

Meftahuddin, T. 2002. Review of the trends and causes of food borne outbreaks in Malaysia from 1988 to 1997. The Medical Journal of Malaysia 57(1): 70-79.

Michino, H. & Otsuki, K. 2000. Risk factors in causing outbreaks of food-borne illness originating in school lunch facilities in Japan. Journal of Veterinary Medical Science 62(5): 557-560.

MOH. 2016. Health Facts 2017 (reference data for 2016). Kuala Lumpur: Ministry of Health.

MOH. 2014. Annual Report 2014.  Kuala Lumpur: Ministry of Health. Retrieved from https://www.google.com/search?q=annual+moh+report+2014&oq=annual+moh+report+ 2014&aqs=chrome.0.69i59j69i60j0l4.12526j1j9&sourceid=chrome&ie=UTF-8.

MOH. 2009. Food Hygiene Regulations 2009.  Kuala Lumpur: Ministry of Health. http://www.fmm.org.my/images/articles/GS1%20Malaysia/Presentation%20FMM%2 Food%20Hygiene.

MOH. 2007. Annual Report 2007.  Kuala Lumpur: Ministry of Health. https://www.google.com/search?q=annual+moh+report+2007&oq=annual+moh+report+ 2007&aqs=chrome.69i57j0l3.13092j1j8&sourceid=chrome&ie=UTF-8.

Nordin, N.H., Razman, M.R. & Zakaria, S.Z.S. 2016. Ministry of Education on healthy school canteen’s management towards quality of life in Malaysia.

Nor-Khaizura, M.A.R., Teoh, C.Y., Sukor, R. & Nor-Ainy, M. 2015. A case study on knowledge of hygiene among food handlers in Foodservice Complex, Universiti Putra Malaysia. In Hospitality and Tourism 2015: Proceedings of HTC. Malacca, Malaysia: CRC Press. p. 295.

Proietti, I., Frazzoli, C. & Mantovani, A. 2014. Identification and management of toxicological hazards of street foods in developing countries. Food and Chemical Toxicology 63: 143-152.

Salleh, W., Lani, M.N., Abdullah, W.Z.W., Chilek, T.Z.T. & Hassan, Z. 2017. A review on incidences of foodborne diseases and interventions for a better national food safety system in Malaysia. Malaysian Applied Biology 46(3): 1-7.

Soon, J., Singh, H. & Baines, R. 2011. Foodborne diseases in Malaysia: A review. Food Control 22(6): 823-830.

Teh, N.S.A., Ab Hamid, M.R., Mohd Asmawi, U.M. & Md Nor, N. 2016. Food hygiene's knowledge, attitudes and practices between urban and suburban adolescents. Procedia-Social and Behavioral Sciences 234: 36-44.

Weaver, E.R., Agius, P.A., Veale, H., Dorning, K., Hlang, T.T., Aung, P.P., Fowkes, F.J. & Hellard, M.E. 2016. Water, sanitation, and hygiene facilities and hygiene practices associated with diarrhea and vomiting in monastic schools, Myanmar. The American Journal of Tropical Medicine and Hygiene 95(2): 278-287.

Whiley, H. & Ross, K. 2015. Salmonella and eggs: From production to plate. International Journal of Environmental Research and Public Health 12(3): 2543-2556.

WHO. 2017. Thailand 2015 Global School - Based Student Health Survey. Bangkok: World Health Organization.

WHO. 2015. WHO Estimates of the Global Burden of Foodborne Diseases: Foodborne Disease Burden Epidemiology Reference Group 2007-2015. Geneva: World Health Organization.

Zin, M., Auzureen, A., Aklilu, E., Goriman Khan, M.A.K., Hamdan, R., Ibrahim, A.S.I. & Soon, J.M. 2017. Microbiological quality of cooked meat products sold in Kelantan, Malaysia during Ramadhan month. International Food Research Journal 24(1): 414-421.

*Pengarang untuk surat-menyurat; email: afilza@usm.my