Food safety knowledge, attitudes, practices, and associated factors: A cross-sectional survey of Nepalese consumers

Foodborne illnesses remain a significant public health concern in low- and middle-income countries like Nepal. This study assessed the knowledge, attitudes, and practices (KAP) of Nepalese consumers regarding food safety and identified associated sociodemographic factors. A cross-sectional online survey was conducted among 620 participants using a structured questionnaire comprising 60 KAP-related questions. Logistic regression analyses were used to explore associations between KAP scores and participants' characteristics. The median scores for each knowledge, attitudes, and practices domain were 18/20 (90 %), 16/20 (80 %), and 13/20 (65 %), respectively. In the multivariable logistic regression analysis, education level was significantly associated with knowledge and attitudes domains: knowledge ( p < 0.001) and attitudes ( p < 0.001), with participants holding higher education generally more likely to report appropriate food safety knowledge and attitudes. However, practices related to food safety were not associated with the level of education. Gender was significantly associated with food safety practices ( p = 0.012), and male participants had 36 % lower odds of having a good practices level compared to female participants (OR=0.64; 95 % CI: 0.45–0.91). Overall, despite demonstrating better knowledge and attitudes, participants in our study exhibited a comparatively lower levels of practices. This finding indicates a substantial gap between KAP domains, highlighting the need for targeted public health interventions, behavior-focused education, and gender-sensitive strategies to improve food safety practices and reduce the burden of foodborne diseases in Nepal.