In the continuum from ‘farm to fork’, the proficiency of food handlers in terms of knowledge, attitudes, and practices (KAP) is essential for ensuring improved food safety outcomes. This study evaluated the KAP of fresh Nile perch fish handlers regarding food safety requirements within Uganda. A cross-sectional survey involving fish handlers (n = 466) engaged in handling fresh Nile perch and fisheries products in both local and export market chains. The study was conducted at 30 gazetted fish landing sites on Lake Victoria, 15 licensed fish export factories, and 9 local markets authorized to sell fisheries products. Data on demographic, knowledge, attitude, and practices was collected using structured questionnaire. Demographic data was analysed using frequencies and percentages. Ordinary least squares bivariate and multivariate regression analyses were performed to determine factors associated with knowledge, attitudes, and practices regarding food safety requirements. Fish handlers (49.8 %) demonstrated good knowledge with the majority (74.6 %) from the export market chain. Majority (81.3 %) of market stall handlers had poor knowledge of food safety requirements. Most (68.2 %) fresh Nile perch fish handlers had limited awareness of food-borne pathogens. Only 31.8 % had knowledge about E. coli, Salmonella spp, and Staphylococcus spp. Furthermore, over 63 % believed that consuming contaminated fish could transmit HIV, Covid-19, and Ebola. Male gender, higher income, and advanced education were positively correlated with fish handlers' knowledge of food safety requirements. Fish handlers (57 %) in the local market chain exhibited poor attitudes. Being a male fish handler was significantly (β = 3.43, 95 % CI: 1.65–5.21, P = 0.001) associated with positive attitudes compared to being female. Education at different levels was significantly (Primary (β = 3.19, 95 % CI: 1.05–5.33, P = 0.004); Secondary level (β = 5.883, 95 % CI: 3.52–8.23, P = 0.001); Tertiary (β = 6.09, 95 % CI: 3.03–9.15, P = 0.001)) associated with positive attitudes compared to no education.Practices ensuring food safety were common in the factories and the export market. The study suggests the need for interventions that promote knowledge transfer and food safety culture, particularly in the local market chain.
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