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Abstract
Background: Vibrio cholerae produces cholera which is an endemic health problem in the low and mid level income countries; conditions of poor food safety and poor sanitation systems pose threat to cholera outbreaks in these countries. Water systems and cholera outbreaks have a well established relationship; however, fish and seafood in the urban areas can be a potential exposure source.
Objective: This study aims to quantify the risk of cholera associated with fish from the market and among fish consumers in Karachi, Pakistan.
Method: A cross sectional study was designed to observe 10 different retail fish markets in Karachi that also includes a survey consisting of three hundred households.
Results: During current survey it was found that 40% of the markets had no proper waste disposal systems and no running water, while 50% of the markets had no fish refrigeration systems, and cross contamination was seen in 50% of the markets. From the surveyed households, 65% of respondents stored fish at room temperature for more than 2 hours, 42% cleaned fish with potentially unsafe water, and only 33% used clean utensils to handle raw fish. The average risk score of the surveyed households was 6.3±1.7 that showed 52% were in a high risk category. Low risk awareness, absence of refrigeration, cross contamination, prolonged ambient storage, and unsafe washing practices were considered high risk practices among respondents (p<0.05).
Conclusion: These practices indicated that the risk of cholera is high with both poor supply chain practices as well as with urban poor public health practices. To reduce potential exposure and related threats to public health in urban areas fish market infrastructure, refrigeration systems, and fish supply chain systems, along with regulatory systems and public education, should be improved.