Good Hygiene Practice Interventions for Safer Pork at Traditional Markets in Cambodia

• Selection of provinces, markets and retailers

Six provinces were selected including Phnom Penh, Siem Reap, Takeo, Kampong Cham, Kampot, Kampong Speu with the following selection criteria: i) The number of markets in provinces, ii) Salmonella prevalence (above 50%), iii) Population density and risk, urban - rural, iv) Distance from laboratory, v) Compliance of market board and traders, local animal health workers. Phnom Penh had a reported Salmonella prevalence of less than 50% in the recent market study but was included as an urban center with expected high output of pork sells. In each province, four markets which have at least 15 pork shops will be selected. Among those markets, two markets will be assigned for control and trial groups.

Group of retailers will be chosen from selected markets for the intervention based on their "similarity" (e.g., environment, shop facilities, sells volume) and their compliance to participate. Intervention package includes providing incentive equipment and training on good hygiene practice. Equipment provision comprise: (i) equip the shops with inox trays and advise them to separate raw pork/processed pork and intestines; (ii) In case the surface of the shop is not made from granite or inox, we will provide them with feasible surface cover material; (iii) Apron to retailers with the project logo/brand; (iv)Shop's banner with our logo; (v) Hand washing soap (antibacterial) and dish detergent; (vi) Disinfectant spray (Anolyte).

Guide retailers to rearrange their shops to suit their own facility and space. Introduce plastic cutting boards for light cut, check currently used wooden cutting boards at shop to advice to use properly. Introduce frequent washing and disinfection of sale place and shop equipment. Washing with dish detergent and disinfection using spray disinfectant (Electrochemically activated water, pH=7). This shall include:

• Cutting boards. Washing with dish detergent (soap) and water with scrub, then disinfection using spraying bleach. Leave for five minutes then rinse with water (can also be a spray) and let it air dry. At least prior to open or after closing the shop and once in between.
• Knives. At least prior to open or after closing the shop and once in between.
• Cloth. Guide how to use cloth. Each shop should have 2-3 cloth to wipe separate surfaces/tools.
• Table surface. Require retailers to wash and disinfect throughout at the end of selling day; and apply disinfectant spray at the beginning of the selling day. Only retailers with an easy to clean surface (inox, granite or plastic etc.) shall be selected.
• Training. Introduce frequent washing of hands, at least once within each selling hour, with clean water and liquid soap, and dry by tissue paper. Proper disposal of tissue paper in closed top bin

For control group: No intervention or training activities for this group but collection of biological samples and observation checklist to determine hygienic status at their shops over three consecutive days.

• Intervention description

• Procedure to introduce the intervention:

• Introduce and discuss trial with market authorities and vets (as appropriate)
• Identify potential retailers, discuss and make plan with them
• Pre- evaluate current knowledge and practice of selected retailers.
• Procure suitable (shop size) equipment for "trial" retailers
• Provide training, instructions and guidelines for selected retailers and introduce equipment
• Monitoring of hygienic practice, sampling and checking practice of retailer
• Timelines: "Training and equipment" in the 1st week, follow up, and supervise in week 2-4, sampling will be conducted in the fourth week.
• Summary report, sharing and discussion with trial retailers to re-evaluate their knowledge.
• Procedure for sampling and analysis:

• At each market, 15 of pork vendors will be selected for sampling.
• From each vendor, one specimen will be purchased approximately 300 to 400 grams each.
• All pork samples (n=360) from trial and control groups will be tested for total bacteria count (TBC).
• In addition, a sub-set of 60 cut pork samples of trial group will be also analyzed for Salmonella Yes/No (qualitative), 30 out of 60 of these samples will be quantified for Salmonella concentration using MPN method.

Inclusion criteria

• Under selected markets
• Selling pork only
• Daily selling
• Voluntary

Exclusion criteria

• Out of the age range 18-65