Assessment of knowledge of histamine fish poisoning among health care personnel and fish consumers in Dar es salaam region

Abstract

Background information Histamine fish poisoning which is also called scombroid fish poisoning is a mild to moderate form of food poisoning caused by eating spoiled or bacterial contaminated fish after capture or during subsequent handling and storage. Its symptoms are similar to those of fish allergy and because of that most physicians misdiagnose it. Aims of the study The objective of the study was to assess knowledge of histamine fish poisoning (HFP) among fish consumers and health care personnel in Dar es Salaam. Methods It was a cross sectional design study, utilizing a pre-tested structured questionnaire with pre-set ten questions pertaining to symptoms of HFP for fish consumers and twelve pre-set questions for health personnel. Two hundred and eighty fish consumers and one hundred and five health care personnel were recruited in the study through convenient sampling. Results The study showed that majority of fish consumers not aware of HFP, and awareness was found to be 26.6%, male (54.1%) being more aware than female (45.9%). Also, 43.2% fish consumers with age group 26-40 years had higher awareness than other age groups, though awareness was insignificantly associated with sex (P=0.153) and age groups (P=0.153). Among health care personnel interviewed, awareness was found to be high (60%) and all physicians had awareness while only 17.2% of clinical officers interviewed had awareness of HFP. Awareness among health workers was significantly associated with their medical cadres. The study also showed that 97.8% of the fish consumers interviewed had low knowledge about HFP and 2.2% had average knowledge. Among health personnel, 28.6% had low knowledge, 57.1% had average knowledge and 14.3% had good knowledge. All clinical officers interviewed for knowledge assessment of HFP expressed low knowledge level, while physicians and residents were the only cadre with good knowledge among health care personnel. Both scombroid and non scombroid fish were listed by respondents being responsible for HFP; mackerel was frequently listed followed by tuna and king fish for scombroid fish, while Nile perch, xii Cat fish and Tilapia were frequently listed among the non scombroid. Symptoms that were recorded among the respondents included rashes, diarrhea and skin itching. Conclusion There is a need for training healthcare personnel particularly clinical officers who had low knowledge of HFP and work in peripheral health facilities where allergy tests are not done. Training should highlight how to distinguish fish allergy from histamine fish poisoning, to avoid misdiagnosis. This can be achieved by explaining the significance of making recall of previous history of allergic reactions to incriminated food (fish), since lack of previous history of allergic reaction and high attack rates in group out breaks, implies HFP and not fish allergy. Awareness campaign to fish consumers and the general public on HFP should be conducted to advocate the significance of fish handling after catch by fisherman and during processing, sale and storage, through icing and refrigeration.