Assessment of knowledge, attitude, self-reported behavior of food handlers, and the microbial contamination of milk in the school feeding program in Maseru, Lesotho

Food insecurity remains a global challenge, with developing countries enduring more impact. To curb this challenge, school feeding programs (SFP) have played a critical role. Nutrient-rich foods provided through school feeding initiatives must meet strict safety standards to avoid foodborne illnesses. Milk is among the most nutritious foods that are very affordable across the globe; however, it is easily and highly susceptible to contamination. Food safety remains a crucial component of public health, especially in programs targeting vulnerable populations such as school children. Against this background, the present study aimed to investigate the microbial content of milk served to children through the SFP in selected primary schools in Maseru and to assess the knowledge, attitudes, and self-reported behavioral practices of food handlers in relation to milk safety. Pasteurized milk was obtained from a common source by 16 primary schools participating in the SFP. Structured questionnaires were administered to food handlers to gather data on knowledge, attitude, and self-reported behavior. Milk samples were examined for microbial quality using selective microbiological agars. On average, 13% of the food handlers expressed a lack of knowledge of the diseases that are transmitted through contaminated milk, while 44% perceived that clean water could be identified with the naked eye. Less than 50% of the food handlers understood that cold milk implied safe milk, even without refrigeration. Coliforms (2×100 and 2.33×102 CFU mL⁻¹) and yeast and molds (1.43×102 to 9.3×103 CFU mL⁻¹) occurred above threshold limits in all the samples. Escherichia coli counts ranged from 2×100 to 2.3×101 CFU mL⁻¹, which is a call for concern. The total bacterial counts indicate the presence/growth of microorganisms in all the milk samples, thus suggesting contamination. The knowledge, attitude, and self-reported behavior of the food handlers reported in the study could guide the food safety routine program.