A Comprehensive Review of the Microbiological Safety of Street Foods in Ethiopia: Prevalence, Risks, and Mitigation Strategies

Abstract

Street foods constitute a vital component of Ethiopia’s urban food system, providing affordable meals and sustaining a large informal workforce. However, concerns regarding their microbiological safety remain substantial. This review aims to systematically integrate and critically appraise published evidence on the prevalence of microbial contamination in Ethiopian street-vended foods, associated health risks, determinants of contamination, and emerging antimicrobial resistance patterns. A structured narrative review approach was employed. Peer-reviewed studies published between 2000 and 2025 were identified through searches of databases including PubMed, Scopus, Web of Science, and Google Scholar. Studies were included if they reported microbiological analyses, quantitative risk assessments, or food handling practice evaluations related to street foods in Ethiopia. After screening for relevance and methodological clarity, eligible studies were analyzed and integrated qualitatively. Across the reviewed literature (n = 18 microbiological studies; cumulative sample size > 1500 food samples), contamination levels were consistently high. One frequently cited cross-sectional study from Jigjiga City (n = 132 samples) reported that 72% of food samples contained at least one pathogenic bacterium, including Staphylococcus aureus (64.4%), Escherichia coli (51.5%), and Salmonella spp. (19.7%). Quantitative microbial risk assessment (QMRA) studies (n = 2; > 500 samples combined) estimated infection probabilities approaching 100% under high-exposure scenarios, particularly among frequent consumers of raw or minimally processed animal source foods. These estimates reflect worst-case exposure assumptions involving elevated contamination loads and repeated consumption patterns. Evidence from behavioral and observational studies (n = 6) indicates that only approximately 40% of vendors demonstrate satisfactory food handling practices. This estimate derives from aggregated findings across multiple regional surveys rather than from primary field data collected by the authors. Poor practices were significantly associated with lower educational attainment, limited income, and inadequate access to water and sanitation infrastructure. Emerging concerns regarding antimicrobial resistance were reported in five recent studies, which documented multidrug-resistant strains of Salmonella and E. coli in street-vended foods. Although these studies represent a smaller proportion of the total literature, their findings signal an escalating public health threat requiring urgent surveillance and intervention. Overall, the evidence demonstrates widespread microbiological contamination driven by infrastructural deficits, hygiene limitations, regulatory gaps, and socioeconomic constraints. An integrated, multisectoral intervention framework is proposed, emphasizing vendor training, infrastructure improvement, risk-based regulation, and consumer engagement to enhance food safety while preserving the sector’s socioeconomic importance.