Microbiological quality of urban-vended salad and its association with gastrointestinal diseases in Kumasi, Ghana

The influence of consumption of salads on exposure to gastrointestinal diseases was assessed in urban environments in Kumasi, Ghana. Data was collected using a cross-sectional survey involving 15 salad sellers and 213 consumers and microbiological laboratory analysis of 96 samples of ready-to-eat salad. Findings showed higher contamination in street-vended salads than those in cafeterias with thermotelerant coliforms levels of 4.00–5.43 log units per 100 g salad, 32% of samples had Salmonella sp ., and 17% had helminth eggs. Overall, there was an insignificant inverse relationship between salad consumption and gastrointestinal diseases among street salad consumers (RR = 0.81) and a strong positive relationship with cafeteria consumers (RR = 5.51). However, stratified analysis on relative risk showed a likelihood of strong influence from other risk factors embedded in socio-economic status such as poor sanitation. We recommend more integrated studies on risk factors for gastrointestinal diseases in poor urban areas.