Introduction

Internationally, there has been a recognition of food safety as one of the major hindrances to development in both developed and underdeveloped nations.¹ The United States, for instance, has been estimated by the WHO to lose over 5 billion dollars as a result of food safety issues, especially, foodborne diseases.² Food safety with regards to diseases is said to be competing with other major killer diseases such as tuberculosis, HIV/AIDS, malaria, etc.³ WHO, stated that about 98% of the food safety burden comes from underdeveloped nations. Moreover, Africa, in general, is said to report more deaths and hospitalizations concerning food safety issues.⁴

The food safety testing market in the world is estimated at a value of 5.1 billion United States dollars for Europe in 2019, and projections are that, by the year 2025, this value is expected to rise to 7.2 billion dollars. The other testing values for other regions from 2017 to 2025 are represented in Figure 1 for 8 years. North America in 2017, 2018, 2019, and 2025 was the highest in these values, followed by Europe, Asia-Pacific, and the Rest of the world combined, yet with the lowest values.⁵ The variation between regions was found to be highly significant (P ⩽ .0058) and that of years (P ⩽ .007) as well.

Figure 1.

Projected worldwide food safety testing market trends (2017-2025), variations between regions were highly significant (P ⩽ .0058) at an alpha level of P < .05, and variations between years were also significant (P ⩽ .007).

Ghana and Nigeria have food regulatory bodies, yet the application of food standards in the food industries seems to be problematic. Right from the selection of seeds to sowing in line with the appropriate cultural practices until harvesting and marketing cannot be guaranteed. This alone stands as an agent for microbial, chemical, and fecal contamination, heavy metals poisoning, pest infestation, parasitic infection, and other physical and chemical contamination.⁶ The necessity of conducting reviews to reveal the current challenges in the food industry to elucidate the issues of food safety is a necessity. Local markets with little or no attention to food regulations receive few or no research publications in these 2 countries. Though it has been documented that, the local markets are the larger sources of foods in Ghana and Nigeria, there is not much attention to their application of food safety standards by food regulatory bodies such as the FDA.⁷ There is, therefore, the need to verify by way of a review to unveil the truths and clarify the challenges, with key facts to find solutions to the identified complications.

Methodology

To establish the challenges confronting food safety and possible solutions in sub-Saharan Africa especially Ghana and Nigeria, a systematic review of the literature was conducted. A literature search plan was designed and executed. First of all, search sites including university repositories, google scholar, PubMed, Science Direct, Nature publications, Sage, Statista, and other reputable sources of publications were established and used for the study. Search styles were basically by the adaption of the Boolean operators such as “AND” “OR” and “NOT” were used. The search terms include “food contamination,” “food poisoning,” “Parasitic contamination of food,” “Pesticides traces in food,” “Weedicides traces in food,” “heavy metals in food,” and “Biological and Physical agents of food contamination,” “Outbreaks of foodborne disease in Ghana,” “Outbreaks of foodborne disease in Nigeria,” and others.

The inclusion criteria are reports on food safety issues published in reputable journals and are current in Ghana or Nigeria. The study employed 5 different searches. Search 1 was conducted, 2 months before search 2, and search 3 was conducted 1 month after search 2. Searches 1, 2, and 3 were all done in 2019 while searches 4 and 5 were done in 2020. Search 4 was done in the first month of 2020 while search 5 was done in March 2020. In all, 2631 documents were found. Out of this, some were research articles, review papers, case studies, news reports, book chapters, etc. Elimination techniques were established and employed in choosing the documents for the research. Out of the total of 2643, about 1621 were found to be duplicates, ordinary surveys (questionnaires/descriptive surveys), and others were found to contain invalid references (these references could not be traced or are nonexistent). And an additional elimination was done after going through the abstract and the titles of the documents. While the exclusion criteria were papers published in Ghana and Nigeria and merely on surveys were excluded. After all these rigorous processes, a total of 115 papers were finally found to be eligible for the review but are too many hence a random selection of 69 papers was then done after the final selection of all included papers. Concerning the desktop review technique, all documents finally chosen were then printed, stapled, and coded. The records are included in Figure 1 and Tables 1 to 3.

Table 1.

Food safety trends in SSA.

Table 2.

Studies on Ghanaian situation of food-borne illness.

Table 3.

Food safety issues in Nigeria.

Food Safety in SSA

The region is well known for its stagnation in economic growth due to its inability to utilize technology in its mineral processing and agriculture.⁸ For agriculture, the region has all it takes to grow. However, due to other obstacles, the agricultural sector has been faced with numerous challenges including rainfall, fertilizers, skilled labor, adequate input supplies, and others.⁶³ The SSA specifically wastes a lot of food at farms and also in the entire production chain leading to numerous complications including food contamination.⁹ Food contamination is a leading cause of food insecurity in the SSA, however little or no attention has been paid to this issue in many West African countries including Ghana and Nigeria.¹¹ To be self-sufficient in food, one needs fertile land and good labor, fortunately, SSA has all these, yet suffers from food insufficiency. The paucity of farm inputs such as fertilizers and the right quantity of water for crops to grow is said to be a hindrance.¹² The SSA is largely dependent on rainwater for most agricultural activities but most areas in these regions lack adequate rains fails. They also suffer from fertilizer prices where many local farmers are unable to afford the fertilizer quantity required by their crops.¹³ All these leads to forfeiture of yield and the few produce are now for the survival of the fittest.

Sub-Saharan Africa with all its fertile lands and labor is not able to produce food to match the population growth.¹⁴ The population of SSA as of 1960 was over 220 million and with a GDP of over 29 billion. Meanwhile, the population of SSA in 2018 was beyond 1 billion and its GDP is over 1.6 trillion.⁶⁴ The production section is unable to meet the growing population as a result of its inability to solve the problem of food safety. Many countries in this region such as Ghana have less attention to food contamination and foodborne illness which is a major contributing factor to food insecurity.¹⁵ Table 1 below presents studies on food trends in SSA.

Determinants of Food Safety

Figure 2, points out various factors that alter the quality and safety of Foods. These factors have been explored in detail in this review.

Figure 2.

Factors that determine the safety of foods.

Food Safety in Ghana

Ghana has been experiencing beyond 626 000 food poisoning prevalence throughout the country yearly, about 298 100 cases of hospitalization yearly,¹⁸ accounting for over 48% of all food poisoning issues reported.⁴¹ Mortality with regards to food poisoning has been over 90 000 individuals yearly contributing to about 14% of all hospitalizations in Ghana.¹⁸

The government of Ghana has suffered a loss of over 70 million united state dollars yearly in its quest to reduce the foodborne disease menace.⁶⁵ Numerous homes have also incurred injuries in physical bodies and also financially. Some homes were completely taken away by the outbreak of diseases such as cholera and typhoid fever in Accra.⁶⁶ On the Cape Coast and some other major cities in Ghana, cholera and typhoid outbreaks occur annually.^67,68 This has been a great determent to the country though their food production has been quite good as is always, somewhat above their rate of population growth.

There are numerous points of contamination of food in Ghana but the common ones include cooking food in unhygienic environments and using unhygienic methods of cooking, using wrong or improper storage systems for most foods.¹⁶ As for drinks, some even use inappropriate sweetness, coloring agents, syrups, and preservatives.¹⁸ Also, the addition of sexual provoking agents to gain customers, and the addition of caffeine to most drinks or caffeine substances to boost alertness in consumers.⁶⁹ Some food handlers also have very poor personal hygiene, poor environmental sanitation, and prepare food in contaminated environments, shocked gutters, and other places prone to higher amounts of most etiological agents responsible for causing foodborne illnesses¹⁶ (Figure 3).

Figure 3.

Schematic diagram for the origin of foodborne illness.

Food poisoning occurs when chemical agents from microbes such as toxins, for example, Shiga toxins are present in food and can cause illness to consumers either animals or humans.²¹ Numerous studies in Ghana have revealed the incidence of chemical poisons such as lead, arsenic, and others.^22,70 In the year 2013, a study revealed the occurrence of lead in street food sold in Ghana.²⁵ Other studies revealed the existence of numerous other chemical substances which are at a dose of even harming humans and animals instantaneously.¹⁸ Chemicals contaminations come from the water and pesticides used in the production of crops, especially fruits and vegetables.¹⁸ Notwithstanding, studies on fresh produce also recorded the incidence of pesticides and other chemicals in salad and other vegetables and fruits.^71-74 Fertilizers and other manures such as fecal matter from both animals and humans used for farming without treatment also serve as a source of contamination.¹⁹ Similarly, some other studies have also confirmed the occurrence of microbial toxins in foods such as those of Staphylococcus aureus, Escherichia coli, Campylobacter, Listeria, and others.^23,75,76 Also, markets and handling matters revealed the highest levels of potential contaminations sources.²⁰ Farming practices are the major main sources of physical and chemical contamination.⁷⁷

Level of Education, Attitude, and Knowledge of Food Vendors and Handlers in Ghana

Studies on sanitation concerning food vendors, and other catering services documented low standards of food hygiene practices among them.^18,32,33,78 Low education has also been of great determent in the Ghanaian government to mitigate foodborne illness.³³ Some of the workers responsible for handling food in the food preparation process have little or no knowledge about food poisoning, contamination, and even hygiene as a whole.^78,79 A study conducted directly on the education level of food vendors in Ghana provided beyond doubt results that significantly show that most food vendors have little or no education at all on food hygiene, appropriate food handling, appropriate food processing coupled with the right techniques, and others.³⁴

Moreover, 2 studies documented that most food vendors do not practice the basic hygiene required of them and per the standards of the food regulations in the country.^66,78 The study shows that pressure on food vendors leads to many of them not being concerned about the safety of the food, especially at most fast-food joints. Vegetables and other fresh produce,^24,26,80 local and exotic chickens,⁸¹ kebabs joints, and chemical contamination.⁸² It can be concluded here that many food vendors and handless are yet to accept and practice to capacity the basic hygiene principles about food in Ghana.

Studies have documented numerous etiological agents isolated from the Ghanaian currency, which is the Ghana cedi⁸³ other studies such as^18,32 also show that over 80% of food handlers and vendors receive cash and use the same hands without washing to serve food (bare hands 89%) to customers.^32,35,84 The worst is that over 29% of the food vendors are illegal.³² They are not having any certificate concerning operational certification. Still,³² a microbiological study on such foods documented that most of the foods contain fecal coliforms over 58% of them, dangerous Salmonella typhi was found to represent 12% although Staphylococcus aureus had 62%, Escherichia coli was 41.7%. Acheampong concluded that the levels of these pathogens were quite above acceptable levels.³² Food hygiene practices have been a challenging issue when it comes to food vendors due to lack of education and most unwillingness to adhere to such rules,⁸⁵ however, for the safety of Ghanaians, and also for economic growth and development, all efforts must be put in place to ensure that they are educated and practice what they have learned.

Microbial Contamination of Food Cases in Ghana

Numerous bacteria cause contamination of food and lead to poor quality of food and sometimes food poisoning. There has been the isolation of numerous bacterial pathogens in both Ghana and Nigeria. Studies conducted on the microbial quality of salad in Kumasi Ghana revealed the presence of Enterobacteria, Salmonella, Shigella, E. coli, Campylobacter, Listeria, and other pathogens which are not even of bacterial origin.^17,41,86 Parasites have also been found to be associated with food in the Ashanti region of Ghana, especially Kumasi. A study at Pankrono Kumasi revealed the presence of numerous parasites in local and exotic chickens sold at marketplaces.^17,81

Numerous studies in Ghana showed the presence of pathogenic agents responsible for causing several foodborne diseases. Notable is a study³⁵ conducted in the capital city of Ghana found that mesophilic bacteria was about 69%, but Staphylococcus aureus was 31%, Bacillus cereus was 5.5% and Enterobacteriaceae was 33%. The study also shows that enteroaggregative Escherichia coli and Shigella sonnei were found to be associated with macroni, tomato set, and rice and light soup containing Salmonella arizonae.

Similarly, reports from Cape Coast Indicated bacterial contamination of meat pie, fried fish, banku with stew, khebab, and others.³⁶ These bacteria included dangerous Escherichia coli from human fecal matter and some fungi were also found in the food said to be “Aspergillus flavus, Aspergillus candidus, Aspergillus niger, Cladosporium herbarum, Penicillium citrinum, Necrospora crassa, Rhizopus, Mucor and Fusarium species”. In the year 2010, Shigella spp., Escherichia coli, Salmonella spp., and Enterobacteriaceae have also been found in most foods sold in Ghana especially in Accra with a contamination rate of 52%. These values were quite above the acceptable levels recommended by the WHO.³⁷

Most ready-to-eat foods including vegetables, fruits, ice-kenkey, “fufu,” macroni, salad, and others were highly contaminated with enteric bacteria which are capable of producing Shiga toxins for poisoning the food.³⁸

Also, the existence of coliform bacteria such as Staphylococcus aureus, Escherichia coli, yeast, and aerobic mesophilic, moulds in some foods sold in Tema and Accra especially ice-kenkey were confirmed.³⁹ Another study in 2014 revealed that some vegetable products such as salad sold in Kumasi Ghana demonstrated higher levels of pathogens such as rotavirus.⁸⁷ Similar studies were conducted in Accra which also revealed contamination levels of Escherichia coli to be 35%, Staphylococcus aureus to be 33%, Klebsiella spp. to be 17%, and finally, Bacillus spp. 15%.⁴⁰

Numerous pathogens have been found in foods in Ghana and have been isolated. A review heightened that, these isolates have a strong link with food-borne illness in the country and hence the need for food safety actions.¹⁷

In recent times, a study established the existence of dangerous mycotoxins and pesticides in food sold in Ghana.²⁷ In 2017, Darko did a similar study in Accra, and mycotoxins were still found in foods indicating that food vendors had done nothing or little has been done to control the contamination of food with mycotoxins.²⁸ The presence of Shiga toxins producing Escherichia coli and Shigella spps in foods in Ghana indicates that such foods should be contaminated with the toxins.^29,88 Also, heat-stable toxin-producing Staphylococcus aureus is associated with several foods sold on the streets of Ghana and in restaurants.³⁰ The reports on the outbreak of Listeriosis in South Africa cautioned the Ghanaians and the government to put measures in place to prevent the outbreak of that disease in Ghana. The etiological agent of Listeriosis is Listeria monocytogenes a bacteria capable of producing extremely poisonous toxins that are highly fetal.^23,89 A study also found Salmonella to be associated with fresh milk in Ghana.³¹ This pathogen has been isolated in Ghanaian foods and therefore a cause for alarm.

This review shows that most foodborne cases have been associated with Enterobacter spp., E. coli, Staphylococcus spp., Pseudomonas spp., and some fungi and viruses in decreasing order of occurrence. Some reviews had similar trends including⁴¹ however⁸⁹ found the opposite except for fungi and viruses. However, most reviews accepted Enterobacter spp to be the most isolated organism from most foods sold in Ghana.

Food Safety in Nigeria

In Nigeria, despite numerous and diverse techniques to solve the problem of food safety, there are still many challenges with this topic in the minds of the people. For food to be secured, then every individual, at any material moment, must have economic access to enough, nutritious but safe food to correspond to their nutritive needs for a good and healthy life.⁹⁰ It is general knowledge that the nutritional quality of a country is determined by food producers (farmers) and management by food processors. In Nigeria health sector reports that over 50% of deaths among children are a result of food safety in Nigeria.⁹¹ Malnutrition alone contributes to over 50% of all deaths among children death in Nigeria.^92,93 Meanwhile, several studies from different other countries have proven that foodborne illness contributes to the highest part of food safety in a country.^94-96 In Nigeria, Foodborne Diseases (FBDs) remain more deadly than Vector-Borne diseases. The government spends a projected amount of US$3.6 billion per annum as the cost for FBDs.⁹⁷ This makes it the leading strain on the healthcare system in Nigeria. Diarrhea alone accounted for “US$854 million” annually as of 2011.⁴⁷

The government of Nigeria has in the past employed tremendous efforts to curtail the problem of food safety. Many organizations have been set up by the government, yet this problem is getting out of hand. It is surely impossible to estimate correctly the levels of foodborne damages to the country. Few cases are reported and analysis is usually based on that.⁹⁸ Unlike Ghana, where many cases are reported, production is far more than population growth, malnutrition is under control, and cholera, typhoid fever, and other disease are now somewhat calm in Ghana.

Food Regulations and Organizations in Nigeria

In the year 2000, the National Policy for Food System and Implementation Strategy (NPFSIS) Policy on Food Hygiene and Safety (FHS) was successfully launched in Nigeria as included in its National Health Policy officially. It has been reported that “Responsibilities for food safety and hygiene practice devolve on different tiers of government and their agencies—federal, state, and local.”⁹⁹ In Nigeria, enforcement of food safety laws and other regulations about the universal safety of food is done mostly at the local level.¹⁰⁰ At the local government, a section has been created to be responsible for carrying out the duties of enforcing laws concerning public health. These laws include all regulations concerning food handling, food hygiene, food safety, catering establishment, etc. Some circumstances warrant the enactment of by-laws at the local government council level to control the problem of food safety within food premises.

Some laws in Nigeria specifically for regulation and control of food include “Standards Organization of Nigeria Decree (1971), the Marketing of Breast Milk Substitute Decree number 41, (1990), the Food and Drugs Decree number 35 (1974), The public health Law/Ordinance Cap 164 (1917/1958), and the Animal Disease Control Decree number 10 (1988).” Others include “National Agency for Food and Drugs Administration and Control (NAFDAC) Decree, number 15 (1999), Consumer Protection Council Decree number 66 (1992), and the Counterfeit/Fake drugs/unwholesome processed Food Decree, number 15, 1999.”¹⁰¹ Following the literature, there is a need to revise the present legislation on food safety in Nigeria as most of them are not applying the current society and food trends in the realities of today’s world.

Cases of Food Safety in Nigeria

The ingestion of food or drinks contaminated with microbes or other chemical substances giving rise to illness or abnormal functioning of the body can be said to be a foodborne disease.¹⁰² Throughout the entire globe, FBDs have been a big problem with an estimated 47.8 million FBDs occurring in just a year.¹⁰² The United States accounts for about 2 million cases while Australia and the United Kingdom account for 5.4 million and 2 million cases each year respectively.¹⁰² With regards to Nigeria, most cases of foodborne illness and food safety are not been reported frequently but documents have it that over 90 000 cases are reported every year.⁴⁵ Australia as a developed country suffers from food safety issues with its population being about 1:7 of Nigeria, Australia records over 4.1 million cases of gastro and over 230 000 reports of Campylobacter and Salmonella accounting for over 55 000 reports.⁴⁵ With regards to the population ratio of Nigeria and Australia, it is obvious that many cases of food safety have not been reported, and could even be over 8 million cases unreported. Based on the high unreported incidences in Nigeria and other developing countries, it will be difficult to design a solution to foodborne illness to meet the situation of the country. Other issues such as the self-prescription of medication instead of going to the hospital and being treated by a medical professional are also other problems. FBDs comes with symptoms such as diarrhea, vomiting and fever which are usually seen as common illness and therefore handled by buying drugs from pharmacy shops and taking self-prescribe medication.⁴⁶

Though there are high levels of unreported cases of FBDs in Nigeria, a few have been reported. For instance, 20 deaths were recorded in Ibadan, Oyo State as a result of consumption of incorrectly preserved sandwiches said to have been contaminated with Salmonella. It has been documented that, food poisoning occurred in Ambrose Alli University and other surrounding environments as a result of staphylococcal aureus poisoning.⁴⁷ In another report, 3 people died and a total of 60 incidences were recorded as a result of eating food during a burial ceremony giving rise to gastrointestinal infections.⁴⁸ Furthermore, 62 people died in the year 2017 at a settlement where most of its inhabitants were Fulani herdsmen as a result of zoonotic bacterial infection responsible for gastroenteritis diarrhea disease.⁴⁷

Intestinal parasites were also isolated from some food handlers’ stools in Ibadan, and the Federal State Capital Territory,⁴⁹ Nigeria, where their loads were said to be extremely higher than expected.¹⁰³ The study concluded by suggesting that food handless should be screened and treated for all forms of FBDs and thought on the general food safety regulations and being supervised the practice of the regulations to the best of their capacities. Lack of standardized hygiene practices could be a source of infections of numerous intestinal helminths, entero-etiological bacteria, and some protozoans.

The use of unsafe water and other equipment in the food production chain contributes to the risk of contamination. International organizations such as WHO maintains that “one of the key principles of food safety is the use of safe water and raw materials for food preparation.”¹⁰² The research indicated that the higher prevalence of Lassa fever in Ekiti State specifically Are-Ekiti rural community was a result of bad practices of processing in the contaminated environment.⁵⁰ Such cases were all dominated by one method called “sundry” a method popularly used for food preservation in that community. For Nigeria, waste disposal alone is a threat to the consumption of food in the country. Most wastes are not properly disposed of providing a breeding site and habitat for most vectors of numerous diseases.^104,105 Most etiological agents such as those responsible for causing disease and conditions such as infantile diarrhea, typhoid, and even almighty cholera in humans are encouraged to persist in such environments.¹⁰⁵

Cholera in Nigeria is said to be endemic and hence seasonal infection.⁵¹ Cholera is said to be higher prevalent during the rainy season in the country and higher again in places where there is very poor sanitation. The outbreaks of cholera in Nigeria can be traced way back to 1970 and 1990 with higher incidences occurring in “1992, 1995-1996, and 1997.”¹⁰⁶ Reports indicate that over 37 200 cases of cholera have been reported in the year 2010 with as many as 1434 deaths.¹⁰⁷ In the year 2011, a similar incidence occurred whereas many as over 22 700 cases were reported and over 720 mortalities with the case-fatality rate being 3.2%¹⁰⁷ in recent times meanwhile Ghana is almost eradicating cholera,¹⁰⁸ and Nigeria 2018 still records over 24 400 cases of cholera with about 830 deaths whilst the case-fatality rate is 1.95% with records from only 20 states out of the total of 36 states in the genesis of 2018 to around October.¹⁰⁹ Cholera cases in 2019 have also been reported recently in Nigeria.⁵²

The burden of diseases like diarrhea in Nigeria is something the government cannot conclude as it is being settled. As of 2014, diarrhea alone accounted for about 5% of the Nigerian general mortality rate among other numerous causes of death in the country.¹¹⁰ Documents have it that, the incidence of childhood diarrhea alone in Nigeria is about 18.8%.¹¹¹ For those children under 5, diarrhea has been responsible for more than 16% of deaths.¹¹² This has been estimated to be about 150 000 cases yearly.¹¹⁰ The higher prevalence of diarrhea in Nigeria has been attributed to the consumption of unsafe water and other issues such as the preparation of food under unhygienic conditions.

Metals and Chemical Poisoning of Food, the Nigerian Cases

Unlike Ghana, many food safety issues concerning food poisoning in Nigeria have been associated strongly with the abuse and sometimes misuse of chemicals used in the food production chain, especially agrichemicals. Lead poisoning has also been recorded in Nigeria.⁵⁵ In addition to heavy metals contamination, Zamfara State also recorded contamination of both lead and copper in water.⁵⁶ Nigeria, a country that has been recognized as among the leading countries with higher consumption of antibiotics, especially for veterinary services has been implicated.^113,114 Remains of some antibiotics such as erythromycin, tetracycline, penicillin, and streptomycin in some livestock products and even poultry meat have been reported frequently.^115,116 Some reports indicate that the values are quite higher than that of the recommended levels of the WHO.¹¹⁶ Not only antibiotics are used abysmally in Nigerian agriculture, but also pesticides. Though these chemical formulations are a necessity in today’s agriculture, they have also been found to be a deterrent to human and other animals’ lives. For instance, in Nigeria, it has been found that pesticides have been used for shielding livestock and crops from numerous infections and pests, and even in fishing.⁴⁷

Farmers in Nigeria also use pesticides to preserve harvested crops such as vegetables including cabbages, carrots and others, beans, and various grains to protect them from the infestation of insects.¹¹⁷ Despondently, the international market has rejected most of the products from Nigeria as a result of higher levels of pesticides remaining in such products. Storage chemicals in Nigeria have also been implicated directly as a reported food poisoning as a result of chemicals used during storage has been demonstrated in Owerri Municipal, some individuals were hospitalized as a result of consumption of pesticide preserved beans.⁵⁷ Still, some students in a second-cycle institution at the Gombe State fell ill after consumption of food said to be containing higher levels of pesticides.¹¹⁸ Some dangerous chemicals such as carbide and balms including other insecticides used in Nigeria for the ripening of fruits have been implicated as well.¹¹⁹

Knowledge and Personal Hygiene of food Handlers in Nigeria

In Nigeria, several reports have demonstrated the levels of knowledge of food handlers and their levels of personal hygiene, organizational hygiene, and environmental hygiene concerning food safety regulations practices indicating that there is a need for rigorous work in the food industry to ensure total food safety in the country.^46,59,120 Research conducted in Owerri, specifically Imo State, revealed on “knowledge of food handlers on food safety protocols,” under various types of food establishments demonstrated very poor knowledge of etiological agents and practices concerning food safety to prevent the association of etiological agents with food.⁴⁶ Many of the respondents did not know that a sick person could also transfer the etiological agents to food (Figure 3). This is one of the major reasons for the invasion of numerous etiologic agents in food environments and probably food itself in Nigeria. Another research conducted in Garki, specifically at Abuja stated that many foods handless lack the knowledge on “food safety and hygiene practices” after an assessment of their level of knowledge on various perimeters on food safety such as “knowledge of food safety in general,” “contamination,” “food poisoning,” and “control measures.” Respondents included both food vendors and owners of the vending company.⁵⁸ Additionally, a study was conducted on the knowledge of nurses who are also food handlers in a tertiary care health care setting and the results indicated that most of them had little knowledge yet does not even practice the knowledge they had.⁵⁹

Concerning various display methods exhibited by food markets including butchers, sellers, and others in Nigeria. Research conducted in the eastern part of Nigeria revealed abysmal and unsanitary conditions concerning the display of food. For instance, it was found that customers usually in their attempt to choose the biggest meat, use unwashed bare hands to touch the food which could probably contain microbes that could contaminate the meat.⁶⁰ Not only customers but even the butchers display the products without any form of coverage to protect them from flies.⁶¹ Most display joins had numerous flies hovering over the meat. The worst has been found with the sellers of the food where raw meat and other food products are been taken with the same equipment used to serve cooked food.⁶² This has been said by the researcher as a source of cross-contamination.

Unlike Ghana where many customers are not likely to buy food with many flies hovering around it, Nigerian consumers wake up one morning and they were advised throughout social media to rather eat food with many flies hovering around them. This was a result of many people who consumed chicken falling ill even news reported this and many photos showed disentombing truckloads of chicken which were said not to be right for human consumption. Nothing as such happened in Ghana but rather imported products have been implicated by the social media in Ghana to be contaminated with some viruses of which there was no proof.

Comparing Food Safety of Nigeria and Ghana

The burden of foodborne illness leads to over 75% of death in Africa which is much higher compared to other continents due to several factors including inadequate access to health facilities.⁹⁰ Nigeria as a populous and transiting African country from lower to middle-income status as a matter of urgency must increase its food safety concerns due to the risk of an upsurge in foodborne illnesses.¹²¹ Havelaar et al⁹⁰ stated that the Nigerian region of the World Health Organization (WHO) monetary expenses have increased as a result of the high foodborne illness which usually arises from diarrheal diseases and helminths. In the same way, WHO reported a higher incidence of diarrheal cases in Ghana.¹⁸ The safety of most foodstuffs in Ghana and Nigeria is altered and this occurs at any point along the food chain continuum, especially at the point of sales.¹²² However, the treatment of foodstuffs by consumers highly reduces the risk of contamination.¹²³ Though a lot of measures and policies have been established by the Nigerian government regarding food safety, they are not well enforced.¹²⁴ Okoruwa and Onuigbo-Chatta¹²⁴ assert that these policies’ coordination amongst various state stakeholders is poor and that inspection, as well as surveillance, has rarely improved. Recently research added that data collection, analysis, and dissemination of reports concerning food safety by the majority (95%) of state agencies were not done but only a little percentage of them were able to combat outbreaks with the well-organized system.¹²⁵ In Ghana, the assurance of food safety is ensured by several governmental bodies, a central body being the Food and Drug Authority.¹²⁶ It is involved in inspecting products, manufacturing companies, and licensing and monitoring products to ensure compliance with food safety standards. However, knowledge of good hygiene practices is very poor amongst food handlers due to low standards of education in Ghana¹²⁷ which agrees with what Grace et al⁹⁸ reported in Nigeria. Moreover, research on microbial food safety of food is declining and thus more studies ought to be conducted.⁸⁹ In both Ghana and Nigeria, food safety studies focused on only urban areas especially Accra in Ghana and Nigeria, which is in the south and central region. Most studies reported that in Nigeria, the origin of foodborne illnesses occurs as a result of insufficient food safety originates from vendors and ready-to-eat foods. In Ghana, however, food safety issues were reported amongst commercially sold street foods and most seriously in institutional catering food services.¹⁸ Moreover, microbial safety of ready-to-ready foods as well as chemical contaminations in vegetables and fruits especially originating from pesticides have been reported.¹²⁸ This necessitates adequate reports and awareness in both countries to improve food safety concerns.

Conclusions

Food safety is a major concern in Sub-Saharan Africa due to the absence of standard cognizance, education, and maintenance of a hygienic environment, which are effective ways to improve food safety. The literature reviewed in this work showed that the most predominant etiological agents isolated in Ghanaian and Nigerian foods are Enterobacter spp., Pseudomonas spp., Campylobacter spp., Escherichia coli., Staphylococcus spp., Aspergillus flavus, and Aspergillus niger. This research work unveiled that food safety challenges do not only involve food poisoning but also pinpointed others such as post-harvest losses, food contamination, poor climatic conditions, financial constraints, and the dormant nature of food laws.

It is very promising that with an active advancement and improvement in technology, good personal hygiene practices, and proper education, challenges to food safety in Sub-Saharan African counties would be curtailed. Despite all these challenges food production in Sub-Saharan Africa is gradually becoming higher, the ministry in charge of Agriculture together with other bodies has put in place urgent measures to tackle these challenges. The growth in Agriculture has helped to reduce poverty in Sub-Saharan African countries such as Ghana and Nigeria. These interventions have led to some countries such as Ghana becoming self-sufficient.

This research work unveiled that food safety challenges do not only involve food poisoning but also pin-pointed others such as post-harvest losses, food contamination, poor climatic conditions, financial constraints and the dormant nature of food laws. Improper handling of food at the local markets and vending sites is a great cause of food contamination in SSA, however, there is not much attention to the application of food safety standards. The food industry has more room for improvement. Good hygiene Principles need to be regulated and enforced. The FDA is a national regulatory body under the Ministry of Health with the power to implement food policies and ensure the safety and wholesomeness of food for consumers. They, therefore, need to strengthen their policies and make them active. People found of producing unwholesome food products should be punished and products ceased. The Ghana Standards Authority is also a body that ensures consumer protection and improved quality and reliability of food. In Nigeria this is not an exception, food laws are relaxed. The National Agency of Food and Drug Administration and Control (NAFDAC) is a regulatory authority with the mandate to regulate and control the manufacture, importation, exportation, advertisement, distribution, sale and use of food. The Standards Organization of Nigeria is also responsible is a body which aims at preparing standards relating to products, measurements, materials and processes among others. It is very pathetic to realize that in all these bodies contaminated foods are still produced and sold in local markets. This calls for the need to probe into the role played by these Authorities in ensuring food safety. There is not much data about food safety in Ghana and Nigeria. Most works centered on food safety at the consumption level and did not give directions for future research.