PROFORMA FOR REGISTRATION OF

SUBJECTS FOR DISSERTATION

DISSERTATION PROPOSAL

“A STUDY TO ASSESS THE EFFECTIVENESS OF SELF

INSTRUCTIONAL MODULE (SIM) ON KNOWLEDGE

REGARDING FOOD SAFETY AMONG MOTHERS OF UNDER

FIVE CHILDREN IN SELECTED AREAS OF TUMKUR”

Ms. SABIHA KHANUM,

IST YEAR M.Sc. NURSING,

COMMUNITY HEALTH NURSING,

BHARATHI COLLEGE OF NURSING,

TUMKUR

2013 - 2015

0

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

ANNEXURE-II

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 NAME OF THE CANDIDATE AND

ADDRESS.

Ms. SABIHA KHANUM

BHARATHI COLLEGE OF NURSING,

TUMKUR.

2 NAME OF THE INSTITUTE BHARATHI COLLEGE OF NURSING

3 COURSE OF STUDY AND

SUBJECT

1st YEAR MSc NURSING

COMMUNITY HEALTH NURSING

4 DATE OF ADMISSION TO

COURSE

5 TITLE OF THE TOPIC “A STUDY TO ASSESS THE

EFFECTIVENESSOF SELF

INSTRUCTIONAL MODULE (SIM) ON

KNOWLEDGE REGARDING FOOD

SAFETY AMONG MOTHERS OF

UNDER FIVE CHILDREN IN

SELECTED AREAS OF TUMKUR”

6. BRIEF RESUME OF THE INTENTED WORK

1

INTRODUCTION

“One cannot think well, love well, sleep well, if one has not dined well.” 

― Virginia Woolf

India is basically an agricultural country. Industrialization and urbanization along

with the tremendous growth in the population have provided people to migrate from their

rural houses to the urban areas in search of employment and a better way of life, which

has forced them to the necessity to have their meals at any place that offers food at a price

they can afford1.

There are many indicators that point to the fact that the incidence of foodborne

disease is increasing globally, and is a substantial cause of morbidity and mortality

worldwide. For industrialized countries in general, it has been estimated that up to one-

third of the population suffer a foodborne illness each year. In the United States, food-

borne diseases cause an estimated 76 million episodes of illness annually. Although the

vast majority of cases are mild, a significant number of deaths do occur and the high

levels of acute infections and chronic squeal lead to billions of dollars in medical costs

and lost productivity1.

It can be assumed that the prevalence of foodborne disease in the developing

world is even higher, although it is difficult to obtain the data that would support this as-

sumption. While it has long been considered that most cases of diarrhea in developing

countries are waterborne, Kaferstein has recently stated that it is a grave mistake to ig-

nore the role of contaminated food and that there is an urgent need to integrate food

2

safety, along with water and sanitation programs, as an essential strategy to prevent

diarrhea. A recent study in developing countries gave an insight into the prevalence

of Campylobacter species, which is the most commonly isolated bacterial pathogen from

children under two years of age suffering from diarrhea. Isolation rates for children under

five years of age were estimated to be between 40,000 per 100,000 and 60,000 per

100,000, compared with 300 per 100,000 in developed countries. The study found that

the major sources of human infection were food and environmental contamination and a

survey of retail poultry sold in Bangkok and Nairobi found Campylobacter species con-

tamination rates of between 40% and 77%. Coker et al reported that this disease is projec-

ted to remain one of the top ten isolated bacterial pathogens globally in 20202.

Although foodborne disease data collection systems often miss the mass of home-

based outbreaks of sporadic infection, it is now widely accepted that many cases of food-

borne illness occur as a result of improper food handling and preparation by consumers in

their own kitchens, as shown in a review of studies. In addition, a study of Escherichia

coli 157 outbreaks in the United States found that 80% of food stuff were prepared and

eaten at home. In Australia, approximately 90% of Salmonella species infections are gen-

erally thought to be associated with non-manufactured foods and the home. Data avail-

able from Canada covering 1996 and 1997 has identified the home as the most common

exposure setting for cases of Salmonella species, Campylobacter species and patho-

genic E coli infection3.

There are a number of factors which are likely to contribute to outbreaks of food-

borne illness in the home, including a raw food supply that is frequently contaminated, a

3

lack of awareness among the general public, mistakes in food handling and food prepara-

tion at home and the deliberate consumption of raw and undercooked foods of animal ori-

gin, often described as 'risky eating behaviour'4.

Raw foods, including meat and poultry, raw eggs, fish and shellfish, and fruits

and vegetables, should all be considered as potential entry sources of foodborne patho-

gens into the home. The list of infectious agents that have been introduced into the home

via food includes species of Salmonella, Camylobacter, Listeria and E coli 1574.

The human and animal occupants of the home can also serve as sources of food-

borne pathogens. Humans and animals can both serve as symptomatic and non-sympto-

matic carriers and also as postsymptomatic excreters. Pathogens can be transferred from

various sources to inanimate contact surfaces in the home or directly to other foods or hu-

man occupants via transient carriage on the hands. Foodborne agents that have been in-

troduced into the home via humans include species of Salmonella, Shigella sonnei, Sta-

phylococcus aureus, rotavirus and hepatitis A virus5.

The four most common mistakes in handling and preparing food at home are the

inappropriate storage of food (including inadequate refrigeration, the failure to attain a re-

quired cooking and/or reheating temperature), any actions that result in cross-contamina-

tion, and the presence of an infected food handler. In a study of 101 home-based out-

breaks, it was determined that inappropriate food storage and cross-contamination were

the most prevalent mistakes, accounting for 50% and 28% of reported causative factors,

respectively5.

4

Foodborne disease will continue to be a matter of major concern around the world

in the foreseeable future, despite some important national successes at reducing the levels

of certain pathogens in foods resulting from better farm practices, food processing regula-

tions, etc. Therefore, it has to be concluded that the 21st century home will also continue

to remain the last line of defence against foodborne pathogens. Public education is seen

as a key factor in improving food safety practices in the home. The benefits of food hy-

giene education would include not only a reduction in the occurrence of foodborne illness

at home, but also a population better prepared to meet the needs of the food industry and

food service sectors of local and national economies.

6.1 NEED FOR THE STUDY:-

“There is no love sincerer than the love of food.” 

5

― George Bernard Shaw

India is the second most country in the world with a total population of over 1081

million people and in this population, the basic needs of human beings like food, shelter

and clothing are very important people to live on earth than any other luxuries6.

In order to understand the challenges to food safety in the home, it is worthwhile

to consider the relevant elements that comprise a typical modern-day home in this early

part of the 21st century. It is also worth noting that in many parts of the world, the home is

in fact a multifunctional setting comprising many activities that may have an impact on

the need for, and practice of, food safety6.

First and foremost, the home is a residence containing occupants of mixed ages

and health statuses. In many parts of the world the numbers of immune-compromised in-

dividuals living in the community is on the increase and, amongst other things, these

people are often at a higher risk for the acquisition of foodborne disease as well as for a

more severe disease outcome. In the United States, the population of immune-comprom-

ised individuals is estimated at more than 30 million people. Again, this puts a renewed

emphasis on the need for food safety in the home, much as might be expected if these pa-

tients were being cared for within the hospital6.

Another growing home-based activity that may impact food safety in the home is

the presence of young children in home-based day care. In the United States, 75% of un-

der-five-year-olds are currently enrolled in day care, representing 13 million pre-school-

ers and six million infants. Much of this child care is home-based, with 25% of all chil-

dren cared for by relatives and 5% by in-home caregivers. There are many reports of out-6

breaks of infectious diseases, including diarrhea, in children's day care settings and the

potential for infection to spread within the home via food is inevitably increased in these

situations. In addition, small and/or unlicensed home-based day care settings are less

likely to have outbreaks reported and investigated, and may therefore, miss advice and in-

formation about the importance of appropriate food safety practices6.

In addition to its human occupants, the home is frequently shelter to a number of

pets, ranging from mundane varieties to the exotic, and many zoonoses, including some

that can cause foodborne infections, can be acquired from both. Salmonella species and

other enteropathogens have long been recognized in association with domestic pets, such

as cats and dogs. Household cats and dogs may also serve as reservoirs for species

of Campylobacter and, thus, are potential sources of infection (20). Exotic pets may also

serve as a source of enteropathogens into the home. It was found that infants in this study

were probably more likely to have acquired infections by direct contact with inanimate

surfaces, such as floors, household pets, and by the consumption of contaminated foods7.

Finally, when considering the question of food safety in the home, we usually

think of food that is prepared and served to the home occupants. However, we should

also consider that the home kitchen may also be used for small home-based business op-

erations that prepare food for catered functions outside of the home, as well as for bake

sales, school and church picnics, etc. In all of these examples, food prepared at home is

served to a wider community. These catering activities are usually unregulated, often take

place in kitchens with inadequate facilities and equipment, and are carried out by people

who may not have taken a training course in food safety. A study of home-based catering

7

operations noted that food was stored inappropriately in the home kitchen on 50% of oc-

casions7.

There are also a number of global factors that have an impact on food safety in-

side the 21st century home. In particular, the globalization of the food supply impacts

homes all over the world. World meat consumption is expected to double between 1983

and 2020, to 300 million metric tons, and most of this increase will occur in developing

countries. The impact on food safety for homes in these countries may be significant,

considering that meat processing may not be well regulated, home kitchens may not be

equipped for storage and preparation of raw meats and the population may not be familiar

with the general food safety guidelines for meat storage and preparation, especially where

the consumption of large quantities of meat protein is a new phenomenon8.

Import statistics indicate that more than 50% of fresh vegetables in the developed

world marketplace are imported from developing countries, prompting food safety ex-

perts to quip that consumers only have to travel as far as the local food market and home

again to experience 'traveller's diarrhea'8.

International travel and tourism to countries with poor standards of food hygiene

may also impact the home. Globally, 1.6 billion people travel by air each year. Rapid air

travel means that people who have contracted gastro-enteric infections may carry these

agents back into their homes, with the potential for further spread within the family and

the immediate community, both directly by person-to-person contact and indirectly by

cross-contamination into the food prepared at home. The potential for this type of trans-

8

mission is seen in a World Health Organization report that states that 64% of tourists ex-

iting Thailand in 1995 were suffering from diarrhea9.

It has been said that there are three major lines of defence against foodborne dis-

ease. The first aims at improving the hygienic quality of raw foodstuffs; the second util-

izes food processing technologies such as pasteurization and irradiation, and employs

hazard analysis and critical control point (HACCP) concepts; and the third line of de-

fence concerns the education of all food handlers, including home-based food handlers.

There are a number of national campaigns, for example the Canadian Partnership for

Consumer Food Safety Education in Canada, the Partnership for Food Safety Education

in the United States, the Food Standards Agency in the United Kingdom, and interna-

tional campaigns, such as the World Health Organization's Food Safety Program, that

aim to inform and educate the general public about the need to better understand and

practice food safety in the home. These campaigns are comprehensive and address real

concerns, but inevitably tend to be web and print media-based and, in this respect, they

are a passive form of information transfer and are likely to be taken up only by that seg-

ment of the population that is actively searching for information. In many countries, the

subject of food safety was traditionally taught as a part of the home economics cur-

riculum in schools, but in recent years the teaching of home economics has largely disap-

peared from many national education programs and, as a result, food safety is not taught.

In addition, changes in family structure, changes in family meal practices and changes in

women's roles in the home and workplace have resulted in a breakdown in the transfer of

information about safe food practices within the family. With increasing concern in many

countries about the levels of foodborne disease and the huge national economic burden 9

associated with these levels, the introduction of mandatory food safety education pro-

grams across schools should be considered as a means of actively educating and engaging

the population in a basic health issue10.

In practical terms, food safety education and information is increasingly incorpor-

ating the targeted hygiene approach developed and described by the International Hy-

giene Forum in their Guidelines for prevention of infection and cross infection in the do-

mestic environment. So there is a greater need for the education regarding food safety at

home to prevent food borne diseases due to contamination of food during production,

preparation, storage and serving of food.

So, researcher felt a need to conduct a study on food safety among underfive mothers,

SIM on food safety will enhance the knowledge of mothers.

6 .2 REVIEW OF LITERATURE:

10

The purpose of review of literature is to obtain comprehensive knowledge base

and in department of information from previous studies.

In a study conducted in Amritsar city, defined food handler as “any person who

handles food, regardless whether he actually prepares or serves it. In a study conducted in

Amritsar, it was observed that 71.90% of food handlers were below 30 years of age and

02.33% were 6 years and above. 96.26% of them were males, 03.74% females, 49.54%

cooks and majority i.e., 68.22% were from rural areas. There were 38.31% of illiterate

food handlers, 53.74% smokers, 24.30% consumed alcohol daily, 11.20% had habit of

chewing tobacco, 10.74% were chewing betal leaves and 31.72% had double habituation.

20.91% of them had history of some illness during past 3 months. 14.00% of food

handlers were suffering from parasitic infestation and among them, Entamoeba

histolytica was found to be common with 42.80% of food handlers affected, which was

followed by Ascaris lumbricoides with 28.60% and 18.22% of them, had anaemia11.

In a study done in Bijapur, Karnataka, it was observed that, 43.66% of food

handlers were between 20-29 year age group, a total of 51.50% were unmarried, literacy

rate was 70.78%, 25.30% of food handlers had mixed habits. In their study 86.15% of

them were of Hindu religion. 29.00% of them were suffering from anaemia and 09.77%

with parasitic infestation. No worker had good knowledge about food hygiene 12.

A study done in Italy, to evaluate knowledge, attitude, and behaviour concerning

food hygiene and food borne diseases among food handlers, with 411 food handlers

responding, 48.70% knew the main food borne pathogens (Salmonella spp, 11

staphylococcus aureus, Vibrio cholera, Clostridium botulinu, Hepatitis A virus), and this

knowledge was significantly greater among those with a higher education level, in

practice from longer period of time, and who had attended education courses. 90.40%

correctly indicated those foods classified as common vehicles for foodborne diseases, and

only 07.10% of food handlers were able to name five different food vehicles, each of

which transmit one of the five pathogens. Only 20.80% used gloves when touching

unwrapped raw food, and predictors of their use were educational level and attending

education courses. Results strongly emphasize the need for educational programs for

improving knowledge and control of food borne diseases13.

A study done on food handlers in Karnataka, it was found that 32.90% were

illiterate, 36.50% of them had done primary schooling, 23.30% had education between 6th

and 8th standards and 07.20% had passed higher secondary examination and above.

83.40% of workers had daily bath, 13.50% had bath on alternate days, and 03.10% had

bath occasionally. Good score for personal hygiene was secured by 60.00% workers,

satisfactory or fair by 22.00% and 18.00% workers scored poor in their personal hygiene.

In their study all the workers had been immunized against Enteric group of fevers and

tetanus. 38.40% of workers suffered from some ailment or other, 61.60% were apparently

healthy, 34.00% were suffering from hypertension, 08.80% had anaemia, 02.60% had

intestinal parasites (only ascaris lumbricoides), 02.90% had Vitamin A deficiency,

02.00% suffering from fungal infections, and 01.60% each had dental caries and skin

injuries14.

12

In another study done in Qualyobia Governorate, Egypt, clinical examination and

stool samples collection on 3 alternative days was performed. The food handlers were

divided into symptomatic (700) and asymptomatic (1000). Intestinal parasites was found

in 19.00% of samples. In 08.50% Blastocystis hominis was recovered from stools of

symptomatic and in 04.00% of asymptomatic, 02.40% of symptomatic and 02.00% of

asymptomatic had B.hominis significant infection. B.hominis was considered significant

if >5 organisms per HPF was counted.15

A study carried out in Salt Lake City, Utah, USA, by Center for Disease Control

and Prevention (CDC) have stated that poor personal hygiene is the third most common

reported food preparation practice contributing to food borne disease. The study reported

here compared the effectiveness of traditional (Lecture/ Video) training with that of

traditional training that provided an added active (hands-on) component of hand washing

procedures. 66 food handlers attending training courses were included in the study.

33.00% of the participants received an additional interactive training component.

Participants involved in the interactive training had statistically significant better test

performance both on the day of training and on the two-week retest16.

In an article published in world health forum, it was stated that to ensure food

safety through legislation have been only partially successful, and the prevalence of food

borne disease is increasing in most countries. Health education on a large scale is needed

to raise the level of public awareness of the factors leading to the spread of these

13

diseases. The best way to do this is through the primary health care system, basing

activities on both scientific knowledge and local food-related customs and behaviour17.

In a study carried out in Nagpur, 22.30% of food handlers were below 25 yrs of

age, 28.90% of them were females, 50.00% of them chewed pan, 40.10% chewed

tobacco, in 69.70% of them parasitic infestation was found and the prevalence of anaemia

was 32.09%18.

In a study titled “Guidelines for the management and health surveillance of food

handlers” in USA, to serve as a guide for persons involved in food handling to practices

which will contribute to safe food handling, stated that, managers should ensure that food

handlers at all times adhere to the following aspects, which should become part of the

customary norms and values of these persons: Hands should be washed and finger nails

scrubbed in warm soapy water before food is handled, after visiting the toilet, after

blowing the nose, after smoking and/or eating, and after handling any soiled objects such

as refuse bin, etc. Hands should be dried with towels and never a communal towel. Finger

nails should be kept short and clean. Keep hands away from the nose, mouth, eyes, ears

or hair during the time food is handled. Fingers should not be licked when preparing

food. Do not prepare or work with food while there are unhealed cuts or sores on the

hands. A clean washable overall or overcoat of a pale color, which will show the dirt,

should be worn. Hair should be kept covered to prevent dust and bacteria it contains from

falling into the food. Never cough, sneeze or blow the nose over the food. Do not smoke,

chew tobacco, etc. while handling food. Be clean at all times and it is recommended that

14

hot bath be taken every day before commencing work. Clean protective clothing should

be worn19.

In a study done in Nigeria, to assess the knowledge and practice of food hygiene

by food handlers found that 88.20% of the respondents were females, and there was a

predominantly poor level of knowledge of food hygiene. There was a very low frequency

of hand washing. Inspection of food handlers showed a low level of personal hygiene.

Only 30.40% had pre-employment medical examination and only 48.00% had received

any form of health education20.

In an article published in WHO Chronicle 1977, it was stated that, the common

faults in the handling and processing of food in homes, restaurants and other food

catering establishments, which led to disease outbreaks were, inadequate refrigeration,

accounting for 336 outbreaks, food preparation far in advance of serving was reason for

156 outbreaks, infected person and poor personal hygiene for 151, inadequate cooking or

heating for 140, food kept warm at a wrong temperature for 114, contaminated raw

materials in uncooked foods for 84, inadequate reheating for 66, cross-contamination for

58, inadequate cleaning of equipment for 52, and other conditions for 160 disease out

breaks21.

STATEMENT OF THE PROBLEM

“A STUDY TO ASSESS THE EFFECTIVENESSOF SELF

INSTRUCTIONAL MODULE (SIM) ON KNOWLEDGE REGARDING FOOD

15

SAFETY AMONG MOTHERS OF UNDER FIVE CHILDREN IN SELECTED

AREAS OF TUMKUR”.

6.3 OBJECTIVES OF THE STUDY

To assess the knowledge of mothers in selected areas regarding food safety.

To assess the effectiveness of SIM on knowledge of mothers regarding food

safety in selected areas.

To compare the mean scores of pretest and posttest of mother knowledge

regarding food safety.

To find out the association between demographic variables with knowledge of

mothers regarding food safety between mothers selected areas.

6.4 OPERATIONAL DEFINITIONS

Assessment: Evaluation of knowledge of mothers in selected areas regarding food

safety.

Self–instructional module (SIM): The word denotes written knowledge

information prepared by the researcher in English language on food safety.

Knowledge: In this study knowledge refers to the correct response given by

mothers in selected areas regarding food safety to the questionnaire.

Food safety: In this study food safety refers to those activities which are practiced

to prevent food from getting contaminated during processing, preparation and

preservation of food.

Mothers of under five children: In this study it refers to women having children

below five years of age.

6.5 RESEARCH HYPOTHESES

16

H1: There will be significant difference in the pre-test and post-test knowledge scores

regarding food safety among mothers of selected areas of Tumkur.

H2: There is a significant association between demographic variables with knowledge

scores regarding food safety among mothers of selected areas of Tumkur.

6.6 ASSUMPTIONS

The knowledge of mothers in selected areas regarding food safety have some

knowledge on preventing contamination of food.

6.7 MATERIALS AND METHODS OF THE STUDY

This study is designed to compare the knowledge of food safety among mothers in

selected areas of Tumkur.

7.0 SOURCES OF DATA

The data will be collected from mothers of under five children in selected areas of

Tumkur.

7.1.1 RESEARCH APPROACH

An Evaluative Approach will be used.

7.1.2 RESEARCH DESIGN

The research design adopted for present study is quasi experimental, one

group pretest and posttest design.

7.1.3 RESEACH SETTING

The study will be conducted in selected areas of Tumkur.

7.1.4 POPULATION

17

The population of the present study includes mothers of under five children in

selected areas of Tumkur.

7.2 SAMPLING TECHNIQUE

Non-probability convenient sampling will be used for the study.

7.2.1 SAMPLE SIZE

The sample consists of 60 mothers, from selected areas of Tumkur.

CRITERIA FOR SAMPLE COLLECTION

7.2.2 INCLUSIVE CRITERIA

Mothers of under five children in selected areas of Tumkur.

Mothers who know to speak and read English or Kannada

7.2.3 EXCLUSIVE CRITERIA

Who are not willing to participate in the study

Who are not available during data collection

7.2.4 METHODS OF DATA COLLECTION

The study will be initiated after obtaining prior permission from the

concerned authorities.

The data will be collected from mothers in selected areas, on knowledge

regarding food safety by administering self-instructional module.

7.2.5. TOOLS FOR DATA COLLECTION

The Structured Questionnaire is used to collect the data from mothers. The

structured questionnaire format contains questions of the following sections.

18

Section A: - Questions related to demographic variables.

Section B: - Questions which aims to assess the knowledge related to food safety.

7.2.6 PLAN FOR DATA ANALYSIS.

The data collected will be analyzed by means of Descriptive and

Inferential Statistics.

DESCRIPTIVE STATISTICS:-

Mean standard deviations and mean percentage of subjects will be used to

analyze the level of knowledge regarding food safety.

INFERENTIAL STATISTICS; -

The Chi Square will be used to find out the association between socio

demographical variables and knowledge score

7.2.7 TIME AND DURATION OF THE STUDY

The time and duration of the study will be limited to 6 weeks or as per

guidelines of university.

7.3. DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTION TO BE CONDUCTED ON PATIENT OR OTHER

HUMAN OR ANIMAL? IF SO, PLEASE DESCRIBE BRIEFLY.

No.

19

7.4. HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION?

Yes, ethical clearance has been obtained from the concerned authority of insti-

tution.

Informed written consent will be obtained from the participants prior to the

study.

Privacy, confidentiality and anonymity will be guarded.

Scientific objectivity of the study will be maintained with honesty and impar-

tiality.

8. LIST OF REFERENCE

1. Mohan V, Mohan U, Dass Lakshman, Lal Manohar. An evaluation of health status of food

handlers of eating establishments in various educational and health institutions in

Amritsar city. Indian Journal of Community Medicine 2001; XXVI(2):80-85.

20

2. Roday S. Hygiene and Sanitation in Food Industry. Tata McGraw-Hill Publishing

Company (New Delhi); 1-53.

3. Michael R, Taylor, Margaret O’K, Glavin, Glenn Morris J, Woteki CE. Food safety

updated: Developing tools for a more science-and risk-based approach. 2003 July; 1-37.

URL:http://www.milbank.org/reports/2003foodsafety/030731foodsafety.html

4. Report of a WHO Consultation, Health Surveillance and Management Procedures for

Food-Handling Personnel. Geneva: Technical Report Series, 1989; 785: 7-46.

5. World Health Organization, International Statistical Classification of Diseases and Related

Health Problems. (Tenth Revision), WHO Geneva, 1992; 31-1175.

6. Abdussalam M. Food safety in the 21st century. Bull World Health Organ 1999; 77(4):347-

351.

7. Microbiological risk assessment series-3. Hazard characterization for pathogens in food

and water. Guidelines WHO/FAO; 2003. URL: http://www.who.int/foodsafety/

publication/micro/en/pathogen.pdf

8. Terrorist Threats to Food. Guidance for Establishing and strengthening prevention and

response systems. Food Sefety Issues WHO 2002; 1-37. URL:

http://www.who.int/foodsafety/publication/general/en/terrorist.pdf

9. Evaluation of Programmes to Ensure Food Safety. Guiding Principles. WHO, Geneva,

1989; 5-46.

10. Guidelines for the management and health surveillance of food handlers. Dept. of Health

Directorate, USA: Food Control; 2000. URL:

http://www.doh.gov.2a/docs/factsheets/foodhandlers.pdf

21

11. Mohan V, Mohan U, Dass Lakshman, Lal Manohar. An evaluation of health status of

food handlers of eating establishments in various educational and health institutions in

Amritsar city. Indian Journal of Community Medicine 2001; XXVI(2):80-85.

12. Udgiri R, Masali KA. A study of health status and food hygiene practices among food

handlers employed in some food establishment of Bijapur city. A dissertation submitted

to RGUHS, Bangalore 2002.

13. Angelillo IF, Viggieni NM, Rizzo L, Bianco A. Food handlers and food borne diseases:

knowledge, attitudes and reported behaviour in Italy. J Food Prot 2000; 63(3):381-385.

14. Rathore AS, Sonker ML. An evaluation of health status of food handlers and sanitary

status of the messes of a training establishment in Karnataka, India. Journal of

Community Medicine 1993; XVIII(1):21-25.

15. Sadek Y, el-Fakohany AF, Lashin AH, el-Salam FA. Intestinal parasites among food

handlers in Qualyebia Governorate, with reference to the pathogenic parasite blastocysts

hominis. J Egypt Soc Parasitol 1997; 27(2):471-478.

16. Lillquist DR, McCabe ML, Church KH. A comparison of traditional hand washing

training with active hand washing training in the food handlers industry. J Environ Health

2005; 67(6):13-16.

17. Report of a WHO Consultation, Health Surveillance and Management Procedures for

Food-Handling Personnel. Geneva: Technical Report Series, 1989; 785.

18. Gupta SC, Ketkar YA. Prevalence of intestinal parasites in food handlers. Indian Medical

Gazettee 1981; 158(8):295-298.

19. Guidelines for the management and health surveillance of food handlers. Dept. of Health

Directorate, USA: Food Control; 2000. URL:

http://www.doh.gov.2a/docs/factsheets/foodhandlers.pdf

22

20. Okojie OH, Wagbatsoma VA, Ighoroge AD. An assessment of food hygiene among food

handlers in a Nigerian University campus. Niger Postgraduate Medical Journal 2005;

12(2):93-6.

21.Keeping food safe from harmful germs. WHO Chronicle 1977; 31:143-149.

9. Signature of the candidate

10. Remarks of the guide.

23

11. 11.1. Name and Designation of the guide

11.2. Signature

11.3. Co-Guide(if any)

11.4. Signature

11.5. Head of The Department

11.6. Signature

12 12.1. Remarks of the principal

12.2. Signature.

24