Environmental Exposure and Contamination Source Analysis of Pathogenic Microorganisms in Restaurant Foods Associated with Foodborne Disease Incidence in Makassar, Indonesia

Abstract

Background: Typhoid fever is an infectious disease that remains a public health concern in Indonesia, particularly in areas with inadequate sanitation. It is caused by Salmonella typhi, which is commonly transmitted through the consumption of contaminated food or water. Makassar City, as a major culinary hub, faces significant challenges in ensuring food safety across various restaurants. Objectives: This study aims to analyze environmental exposure risks in restaurant food associated with typhoid fever incidence in Makassar City by identifying pathogenic microorganisms and assessing potential sources of contamination, including water quality, food material hygiene, environmental sanitation, and food handlers’ hygiene practices during food preparation and serving. Methods: This quantitative study employed a descriptive observational design. A total of 60 restaurants were selected using a purposive sampling method based on location, type of business, and number of visitors. Data were analyzed descriptively and inferentially to determine contamination risk levels and contributing factors associated with typhoid fever occurrence. Results: The findings revealed significant associations between environmental physical conditions (p = 0,002; OR = 0.160), food processing hygiene and sanitation (p = 0.009; OR = 0.214), food handlers’ personal hygiene (p = 0.042; OR = 3.600), and environmental contamination risk (p = 0.023; OR = 0.289) with Salmonella sp. contamination in food. Conclusion: These results highlight the importance of strengthening hygiene and sanitation education for food handlers, implementing the Hazard Analysis and Critical Control Point (HACCP) system, and establishing risk-based sanitation supervision by health authorities. Keywords: Exposure Risk; Restaurant Food; Typhoid Fever Incidence