Knowledge and Awareness of Food Safety, Foodborne Diseases, and Microbial Hazards Among Consumers of Street-Vended Foods in Kandahar City, Afghanistan: A Cross-Sectional Study.

Background: Common foods found in the streets of Kandahar City include flatbreads (naan), fried stuffed flatbreads (bolani), fried meat (kebabs), rice dishes, fried snacks, seasonal fruit juices, and milk and tea sold from carts, small stalls, or open-air market counters near busy marketplaces and transportation hubs. These items are often at risk of contamination due to the contaminated environment. Unsafe food is linked to over 200 diseases, from diarrhea to various cancers, and can cause permanent disabilities and death. It is estimated that 600 million people worldwide fall ill from eating contaminated food annually, resulting in a global burden and 420,000 early deaths. This study aimed to assess the level of knowledge and awareness about food safety, foodborne illnesses, and microbial threats among consumers of street-vended foods (SVFs) in Kandahar City. Methods: A cross-sectional survey was conducted involving 500 residents of Kandahar City who regularly purchase and consume SVFs. Results: The average score reflecting food safety knowledge among consumers was 10.44 (SD = 3.75, range: 3-18), signifying a moderate level of understanding. Consumers belonging to the older demographic (36-45 years) exhibited a higher level of knowledge concerning food safety in comparison to their younger counterparts (18-25 years). A significant proportion of respondents (76%) expressed uncertainty regarding food safety matters when purchasing SVFs, with convenience being cited as the primary reason (34.4%) for acquiring these foods. Furthermore, 45% of the respondents acknowledged that SVFs are more economical than those available in supermarkets and restaurants. Conclusions: Despite the satisfactory levels of food safety knowledge demonstrated by street food consumers, critical areas such as cross-contamination and food pathogens require heightened focus in educational initiatives. To enhance hygiene and safety standards for street food in Afghanistan, the Ministry of Health and regulatory bodies must devise effective programs and implement sufficient regulatory measures.