Urban Environmental Hygiene and Microbiological Safety of Restaurant and Street Foods in Libyan Cities: A Systematic Review
Keywords:
Food safety, Environmental hygiene, Libya, Street food, Microbiological contamination, Sanitation, Antimicrobial resistance, Waste management, Urban pollution, MENA, Foodborne disease;, One Health, WASHAbstract
Background: Libya confronts compounded food safety and food security challenges arising from inadequate urban environmental hygiene infrastructure, multi-source environmental pollution, and protracted armed conflict that has severely weakened public health systems. Despite mounting evidence linking environmental determinants to foodborne disease risks in comparable conflict-affected settings, no comprehensive PRISMA 2020-compliant systematic synthesis has yet examined the urban environmental hygiene–food safety nexus in Libyan cities.
Objectives: This systematic review synthesizes evidence on: (1) urban environmental hygiene conditions—including sanitation infrastructure, municipal solid waste management, water quality, and ambient air pollution—in major Libyan cities; (2) microbiological contamination profiles and foodborne illness risks associated with restaurant and street foods; (3) food handler and consumer knowledge, attitudes, and practices (KAP) regarding environmental hygiene; and (4) effectiveness of food safety interventions, with implications for evidence-based policy and practice.
Methods: A PRISMA 2020-compliant systematic review was conducted across PubMed, Scopus, Web of Science, and Google Scholar (January 2018–January 2026). Boolean search strategies combined geographic, food safety, microbiological, and environmental hygiene terms. Comparative evidence from the MENA and Sub-Saharan Africa (SSA) regions contextualised Libya-specific findings. Quality appraisal employed JBI critical appraisal checklists and AMSTAR-2. Narrative synthesis followed SWiM guidelines.
Results: The initial search yielded 4,287 citations; after deduplication and screening, 94 studies were included (Libya-specific: n=12; MENA: n=23; SSA: n=42; global reviews: n=17). Inter-rater reliability was high (κ=0.87). Benghazi chicken shawarma samples displayed 89.4% bacterial contamination, with Klebsiella pneumoniae (24.5%), Escherichia coli (19.9%), and Citrobacter freundii (18.8%) as predominant isolates; all exhibited resistance rates of 86.7–100% to cloxacillin, amoxicillin, metronidazole, and cephalothin. Five evidence-based contamination pathways were identified: water contamination, sanitation deficits, waste accumulation, heavy metal deposition, and cross-contamination. Multidrug-resistant (MDR) foodborne pathogens affect 14–35% of isolates region-wide (Sifeddine et al., 2025; Donkor et al., 2021; Lule et al., 2022).
Conclusions: Urban environmental hygiene deficits in Libya create multiple, synergistic contamination pathways that severely compromise the microbiological safety of restaurant and street foods. Multi-sectoral One Health interventions—integrating infrastructure rehabilitation, targeted food handler training, consumer education, regulatory modernisation, and climate adaptation strategies—are urgently warranted.
