Foodborne diseases are increasing at an alarming rate, thereby eliciting constant threat to public health worldwide. Approximately, 200 foodborne cases are caused due to ingestion of contaminated food each year. In developing countries, unhygienic practices are main reasons for foodborne diseases. Precise estimate of population-based data on food borne illnessesare scarce in Pakistan. This review focuses to elucidate etiological cause of foodborne diseases dominant in Pakistan from 1990 to 2018. Various databases were searched, and 88 articles related to foodborne diseases were identified. Around 59 articles were included on quality assessment criteria. We determined dominant pathogens associated with foodborne diseases among all provinces of Pakistan. High numbers of foodborne diseases were reported in Sindh. Whereas, Salmonella was determined asprimary cause of foodborne ailments. Most of the reported data on antibiotic resistance was unavailable. Shagella spp were first reported for antibiotic resistance in 1990, and E. coli was reported for multi-drug resistance in 1998. Nevertheless, S. aureus was reported for Methicillinresistant in 2015-16. This study summarize various sources responsible forfood-borne illness, of which unhygienic conditions, poor sanitation systems, lack of proper infrastructure and continuous influx of refugees plays key role in escalation of morbidity rate in the region. We emphasize need of active surveillance system in reducing foodborne outbreaks in future and enable policy makers to set appropriate goals in food safety area. Keywords AFood control, drug resistance, food safety, Pakistan

Foodborne diseases are increasing at an alarming rate in Pakistan. An increase in gastrointestinal disorder outbreaks has demanded implementation of hygiene and quality practices. Food can initiate epidemics and serves as a growth substrate for bacterial and other food poisoning agents. This study evaluates knowledge, attitudes, and practices among food handlers in maintaining food hygiene in Quetta city. A questionnaire-based survey was conducted to highlight gaps in food safety knowledge among the population. Survey results reveal the need for consumer education regarding safe food handling practices. Respondents belonging to every sphere of life participated in this survey. Food safety knowledge, practices, and attitudes of food handlers indicate that food-handling problems are needed to be addressed. Our research showed that respondents were aware of hygienic practices before preparing and eating food. However, more than half of the respondents were unaware that Salmonella typhi is a foodborne pathogen. We found 74% of the male and 26% female food handlers were unaware of proper hygienic practices. More than 65% of respondents had poorly developed sewage system which floods during rainy seasons causing a rise in these diseases. Our survey revealed the need for consumer education regarding safe food handling practices from purchasing food to dealing with home. Unhygienic food preparation standards, unavailability of clean water as major factors of food poisoning in third world countries. Microbiologists should take the load to ensure proper knowledge about food pathogens. Continuous education and training can strengthen food handler's knowledge in required areas.