Abstract
Fermented milk products play a vital role in the diets of Ethiopians. They are produced from either spontaneous fermentation or back-slopping methods at the household level, in which lactic acid bacteria (LAB) and yeasts predominate. As a result, the processing steps are not standardized and overall safety is still of public health relevance. Therefore, quality and safety improvement, standardization of traditional manufacturing practices, and commercialization of products to a wider market are important. Hence, this systematic review aimed to provide a comprehensive overview of the microbiology of traditional Ethiopian fermented milk products, including ergo (spontaneously fermented whole milk), dhanaan (fermented camel milk), ititu (concentrated sour milk or spontaneously fermented milk curd), ayib (traditional cottage cheese), qibe (traditional butter), arrera (defatted buttermilk), and hazo (spiced fermented buttermilk). We followed the Preferred Reporting Items for Systematic Reviews and searched relevant databases and search engines, including the Web of Science, Google Scholar, Scopus, PubMed, ScienceDirect, and ResearchGate. Furthermore, the pertinent literature was checked individually and identified. Dairy fermentation provides shelf-life extension and improves the organoleptic quality of products. Nonetheless, the aforementioned Ethiopian fermented foods may be contaminated with Escherichia coli 0157: H7, Listeria monocytogenes, Salmonella spp., or Staphylococcus aureus due to inadequate processing and handling practices. This systematic review also revealed that these traditional milk products lack consistent quality and safety due to poor hygienic preparation techniques, non-controlled fermentation, and limited knowledge or awareness of small-holder dairy farmers. Therefore, the use of suitable procedures including good hygienic practices and controlled fermentation is recommended.