Abstract
<title>Abstract</title> <p>Food safety is a critical determinant of public health, as contaminated food and infected animal products can trigger severe food borne infections. This cross-sectional survey, conducted from February to March 2025, assessed the sanitary conditions of public food and drinking establishments in Mettu town, southwest, Ethiopia. Utilizing pre-tested questionnaires, observational checklists, physical check-ups, and stool examinations of food handlers, the study evaluated both infrastructure and hygiene practices. The results revealed that while 96.6% of the establishments were privately owned and 86% were owner-managed, 38.9% operated without a formal license and 54.4% were in rented buildings. Physical infrastructure was largely deficient; only 23.6% of the 123 establishments with kitchens achieved a "good" sanitary rating, though formally licensed venues consistently outperformed informal ones. Notably, routine oversight proved highly effective, as establishments inspected within the past year were significantly safer in storing ready-to-use equipment (OR = 6.53; 95% C.I. [3.07, 13.86]). However, health screenings exposed critical vulnerabilities, with 34.5% of tested food handlers testing positive for worm infections. Ultimately, the overall sanitary conditions were unsatisfactory, creating a high risk for food contamination. To mitigate these risks, integrated intervention is required from local health sectors, the municipality, and the Ministry of Trade, Industry, and Tourism. Immediate recommendations include enforcing strict legal licensing, establishing regular sanitary inspections, and implementing proper waste handling systems, and providing structured training for catering managers to ensure rigorous supervision of food handlers.</p>