Consumers’ raw poultry washing practices: A cross-sectional and observational study in eight Southeast Asian countries

Consumers are recommended not to wash raw poultry before cooking since this practice increases risks of cross contamination with foodborne pathogens. However previous studies had identified that consumers were unaware of this incorrect behaviour. This study aims to assess consumers' self-reported and observed raw poultry washing practices in Southeast Asian (SEA) countries. A mixed method design was employed, with data collected via a cross-sectional survey across eight SEA countries, observational studies and semi-structured interviews conducted in Indonesia and Malaysia. Ninety-six percent (n = 2009) of surveyed participants reported that they washed raw poultry at home. Participants from Laos and Philippines, older, married and low-income participants reported washing raw poultry more frequently. The main reasons for washing raw poultry were to remove dirt, slime, blood or feathers and the act of washing makes them feel safer. Participants from Cambodia (OR = 2.855, p < 0.001), Indonesia (OR = 3.208, p < 0.001), Laos (OR = 3.012, p < 0.05), Malaysia (OR = 2.003, p < 0.05) and Thailand (OR = 2.148, p < 0.001) were 2.00–3.21 times more confident about not washing raw poultry upon understanding the rationale that washing does not reduce microbial load. Participants who purchased from supermarkets (OR = 1.785, p < 0.05) were significantly more confident about not washing raw poultry compared to other sources of raw poultry. Our observation study identified various cross contamination pathways including lack of hand hygiene practices, inadequate cleaning and sanitation procedures, and cross contamination of raw poultry and washed water to surrounding areas. Semi-structured interviews revealed that participants preferred to wash raw poultry due to the lack of cleanliness of raw poultry purchased from traditional markets and the act is ingrained in their cultural practice. Due to consumers' preference for freshly slaughtered poultry and perceived cleanliness of raw poultry purchased from traditional markets, hand hygiene practices during and after handling raw poultry and cleaning of kitchen sinks and surrounding areas with soap should be emphasised. Targeted food safety messages and educational campaigns suited to local cultural differences should be conducted. This study presents the first empirical findings on consumers’ raw poultry washing practices in eight SEA countries. Practical implications and further recommendations are provided

Changes in lipid, fatty acid, α-tocopherol and phytosterol content of New Zealand Undaria pinnatifida with the time and location

Seasonal changes in the contents of lipids, fatty acids, phytosterol and α-tocopherol in the brown macroalgae Undaria pinnatifida were investigated in this research. The Undaria samples were collected monthly from June to December 2011 from mussel lines in the Marlborough Sounds. Lipids were measured on a dry weight (DW) basis. U. pinnatifida had a low lipid content which ranged from 17.07 to 45 mg/g dried weight (DW) in blade and between 20.70 and 63 mg/g in the sporophyll. In New Zealand, U. Pinnatifida is always present and growing in summer although its degradation was reported in summer in Japan due to high sea temperatures. The sea temperatures in the Marlborough Sounds (New Zealand) are cool in summer and are conducive for Undaria growth. The saponifiable lipid fraction was derivatised into fatty acid methyl esters (FAMEs) and analysed by gas chromatography flame ionised detector GC-FID to identify and quantify the individual fatty acids in U. pinnatifida. It was found that the level of SFAs increased from winter to summer. In December the most abundant SFA was palmitic acid (C16:0) which was up to 6.49 mg/g in the blade and the predominant MUFA was oleic acid (C18:1n-9c) with a highest level of, 3.40 mg/g, also in the blade. In December, U. pinnatifida was also found to be a richer source of PUFAs than the SFAs and MUFAs. These PUFAs consisted of both omega-6 (n-6 or ω-6) and omega-3 (n-3 or ω-3) PUFAs. The abundant n-6 PUFAs are C18:2n-6, C18:3n-6 and C20:4n-6 also reached a maximum in December. By contrast some of the PUFAs decreased in summer. C18:3n-3, C18:4n-3 and C20:5n-3 fatty acids were higher in winter. The New Zealand U. pinnatifida showed high concentrations of n-3 fatty acids and demonstrated a nutritionally balanced of omega-6 (n-6): omega-3 (n-3) ratio. The unsaponifiable lipid fractions examined contained two principal phytosterols; fucosterol and 24 methylenecholesterol, and the fat-soluble vitamin α-tocopherol. These non-saponifiable compounds were identified by high pressure liquid chromatography with UV/Vis detection (HLPC-UV) and gas chromatography mass spectrometry (GC-MS), followed by GC-FID analysis for quantitation. The unsaponifiable lipid content represented less than 1% of total lipids in U. pinnatifida. α-Tocopherol was the only fat-soluble vitamin identified in New Zealand Undaria. Fucosterol and 24 methylenecholesterol were found higher concentrations in the winter. The content of fucosterol ranged from 146 to 338 µg/g and 24 methylenecholesterol was between 8.4 and 48 µg/g. However, the content of α-tocopherol was relatively high in winter and spring (13 and 14 µg/g) and then slightly decreased in summer (9.6 µg/g). This study showed that U. pinnatifida from New Zealand can be a balanced source of fatty acids and additionally contained the useful antioxidant α-tocopherol

Lessons from an integrated community health education initiative in rural Laos

This mixed-methods study examines annual community events promoting integrated health in Laos using an Ecohealth approach. A Knowledge, Attitudes, and Practices survey of 218 rural households indicated that attendees valued “Community Health Days” and had greater recall of human health topics, but not of animal or environmental health topics, than non-attendees. The survey and organizational observations suggested that such events are opportunities for multi-sector collaboration in the region, yet delivery may be enhanced by refining the vision, topics, and facilitator roles. Research on transdisciplinary education programs is limited, so this study could inform similar initiatives about potential directions and challenges

Understanding Discrepancies in Nutritional Outcomes Among Under-Fives in Laos:A Mixed-Methods Study Using the Positive Deviance Approach

Background: Stunting is one of the main contributing factors in the under-five mortality rate worldwide. In Laos, the prevalence of stunting remains high, particularly in mountainous rural areas. To prevent stunting, insight into positive deviant behaviors can help understand how people can cope or adapt in resource-poor settings. Objective: This study aims to analyze the practices and underlying factors that explain discrepancies in nutritional outcomes in children under the age of 5 in remote mountainous areas in Laos. Methods: This mixed-methods study included all children under the age of 5 living in 6 selected villages. Anthropometric measurements were taken, and a Z-score for stunting was calculated to select the positive and negative deviant children. To identify the causes of discrepancies in childhood stunting, household questionnaires, focus group discussions, observations, and individual interviews with family members and health workers were conducted. Results: Fifty-five percent of children were stunted. Inappropriate care and feeding practices were observed such as providing unbalanced diets and not attending health facilities. Positive deviant mothers were less likely to follow inappropriate practices, experienced less food insecurity, and had higher motivation and autonomy, which resulted in prioritizing their children’s health. An active role of fathers seemed to benefit positive practices within households. Conclusions: The combination of many different practices in which positive deviant families are doing slightly better resulted in less stunting of children. Those practices are related to the household resources, such as access to food and social support; and the mother’s motivation, autonomy, and perspectives on child health.</p

Factors associated with child malnutrition in mountainous ethnic minority communities in Lao PDR

BACKGROUND: Although in many low- and middle-income countries undernutrition is steadily decreasing, nutritional challenges persist in remote communities, such as those in mountainous areas of Lao PDR. Isolated, with limited access to food and to health care and other public services, local diets are low in both quantity and diversity. Data needed to guide policy and planning are lacking. OBJECTIVES: The study aimed to identify the extent of malnutrition and associated factors among children aged 12-47 months in remote mountainous communities in Lao PDR. METHODS: A cross-sectional survey was conducted in Nong district, Savannakhet province, covering 173 households, involving heads of households, mothers and their children aged 12-47 months. RESULTS: The prevalence of undernutrition was very high among the 173 children studied: 72.8% were stunted, 50.3% underweight and 10.4% wasted. Key factors showing significant positive associations with nutritional status were assets (mobile phone or electric rice mill), collection of non-timber forest products, and household dietary diversity. Negative associations were found with experience of malaria and consuming high amounts of white roots and tubers. Immediate causes of malnutrition were prevalent; half the children had insufficient consumption of all micro- and macronutrients. Diseases were highly prevalent; 30% had recently experienced fever. The households in these villages were quite homogeneous. All scored high on causes of malnutrition; 90% of households experienced food insecurity, nearly all lived below the poverty line, and almost two-thirds of household heads and nearly all mothers had had no education. CONCLUSION: This study identified multiple factors influencing child malnutrition, including low household food diversity, food insecurity, and poor feeding practices among ethnic minority people living in a difficult environment with limited resources. Child undernutrition in these poor communities is complex. Interventions are needed in different sectors, including agricultural production, knowledge on feeding and health services

How do the determinants of Exclusive Breastfeeding change over time? A multi-survey quasi-longitudinal study in Lao PDR

Objective This study aimed to assess trends, associated factors, and the changes in these factors for EBF over the last two decades in Lao PDR. Design This study used a quasi-longitudinal design. Descriptive analyses were done with correction for complex survey design. Inferential analyses were done for survey years separately using multiple logistic regression. Finally, pooled logistic regression analysis were done, using interaction terms to quantify the difference in association per year. Setting This study used data from all provinces of Lao PDR collected in the years 2000, 2006, 2011/2012 and 2017. Participants Children aged six months or younger from Lao PDR. Results EBF practice was estimated at 19.03%, 26.87%, 40.67% and 44.89% in the four survey years, respectively. Factors significantly associated with EBF included: Region of residence, ethnicity, wealth index, and age of child. Region and ethnicity saw significant changes in association, the South developing positively over time as well as in the Lao-Thai ethnic group. Having had any antenatal visits was not associated with EBF practice, nor did this change over time. Conclusions Our study shows how EBF trends, and factors associated with EBF, changed over time. We applied an easily replicable methodology to assess similar public health phenomena. We argue that such analysis is particularly relevant for transitioning countries. In such rapidly evolving settings it is crucial to take into account changing underlying factors when assessing and developing public health policy

Consumers’ risk perception of vegetables in Southeast Asia: Evidence from Laos, Cambodia, and Viet Nam

Vegetable safety is a public concern in Laos, Cambodia, and Vietnam—developing countries in Southeast Asia. Eliminating this concern requires insight into factors shaping it. Food risk perception might differ among countries due to the dissimilarities in culture, social, and economic conditions. However, an understanding on this difference is lacking in Southeast Asia. This paper is the first attempt to compare factors influencing risk perception of vegetables in Laos, Cambodia, and Vietnam. Principle component analysis and ordered logit regression were employed on a sample of 1,199 consumers from the three countries. We found trust and perception of hazards influenced risk perception across countries. Gender shaped risk perception in Laos and Vietnam. The importance of vegetables and risk information determined risk perception in Vietnam only, while hazard knowledge and homegrown vegetables were predictors of risk perception solely in Cambodia. Since Laos, Cambodia, and Vietnam are inhomogeneous in risk perception, policy measures to address food risk perception should be tailored to each country