Introduction: Foodborne diseases pose a significant global public health threat, often originating from improper food handling practices. Given the crucial role of food handlers in preventing transmission of foodborne diseases, this study assessed the food safety knowledge, attitudes, and hygiene practices related to foodborne diseases among food handlers in food service establishments in Yeka Sub-city, Addis Ababa, Ethiopia. Method: A descriptive cross-sectional study was conducted among 373 randomly selected food handlers. Data collection involved observing the kitchen hygiene practices and food handling practices through an observational checklist, and administering structured/standardized questionnaires. Statistical analysis was performed using SPSS version 20, with associations examined using the linear by linear association test. Spearman’s correlation assessed relationships between knowledge, attitude, and practice cut points. Pre-testing and Cronbach’s alpha were used to ensure the reproducibility, and reliability of the questionnaire. Results: Majority of food handlers (50.1%) were aged less than 25 years, with 78.8% being female, and attended secondary school (46.4%). The overall knowledge (65%), positive attitude (92.2%), and hygiene practices (44%) of the food handlers toward food safety were good. Regarding the knowledge perspective, gaps existed in understanding disease transmission, notably Hepatitis A and tuberculosis. Although positive attitudes toward food safety were reported, observed practices were inconsistent, with a significant proportion admitting to working while ill. Compliance with uniform and protective gear was lacking. Marital status, Experience in food safety, and Work satisfaction has been shown to affect the knowledge, attitude, and hygiene practices of food handlers in this study. Conclusion: This study highlights critical gaps in understanding disease transmission, and hygiene practices of food handlers in Yeka sub-city. Addressing these gaps will necessitate targeted interventions, including continuous education and training programs. Enhanced regulatory oversight is also needed to ensure compliance with food safety standards in public food establishments.
