الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Diarrheal disease is a major public health problem in most developing countries, especially in children. It accounts for an estimated 12,600 deaths ~ch day in children in Asia, Africa and Latin America. The mai n causes of d i arrhea i nc 1 ude a wide range of batted a (enterotoxigenic and enteropathogenic. E.coli, Campylobacter iejuni, salmonella, shigella, Clostridium difficile and Aeromonas hydrophila, viruses (rotavi ruses, Norwal k agents and enteri c adenoviruses) and parasi tes. Rotavirus is a major causative agent of infantile di arrhea in many parts of the wQt-1 d including Egypt, especially during cold months. Rotavirus is included as a genus in the family Reoviridae, and its double-stranded RNA genome consists of 11 segments. It is spherical in shape, has an int.ermediate size, and is very resistant to most of chemical disinfectants.. Human rotaviruses are antigeni call y reI ated to some an i mal vi r-uses such as the Nebraska cal f vi r-us and the Si mi an rhesus vi rLlS. Human rotavirus can infect adults and children at any age, but mainly infants under three years. main clinical of infection features rotavirus vomiting, fever and diarrhea with variable degrees dehydration. It is documented many r-eports in well The are of f room differht parts of the world that asymptomatic rotavirus infec:ti on (virus shedding+ response shedding serological ~senc:e of diarrhea) and carrier state (virus in onl y) not events and that the presence of are rare rotavirus in feces should not always accuse it for illness. the Symptomatic and asymptomatic rotavirus infections are more common in hospital nur’ser i es settings, and ch i Id care centers. Neonates are said to have usually asymptomatic or minimally symptomatic infetion. This work has been carried out in order to out the between rotavirus shedding and correlation diarrhea in children less than six years and also find to establish the incidence of symptomatic and asymptomatic rotavirus shedding at different ages during that ~eriod of I i f e . The work was carried out during the period from April to October 1989 and it included the stools of 200 children. Half of these children were complaining of diarrhea, while the other were half other symptoms than and diarrhea controls. All children were these complaining of were taken as attending the rehydration center and outpatient clinic of EI-Shatby Paediatric Hospital. Rectal swabs were collected from all children and were examined for the presence of rotavirus antigen by means of enzyme-linked-immunosorbent using Behring kit. The of diarrheal children were also stools assay (ELISA), examined for the presence of salmonella, shigella, EPEC and Campylobacter iejuni, in order to exclude the main bacterial enteropathogens may be present in association with rotavirus. In this work, rotavirus was stools of 9 children (9) out of 100 be present in detected in the diarrheal cases and in 4 (4) out of 100 non-diarrheal children. The presence of diarrhea in relation to rotavirus shedding studied and 9 (69.21.) was out of 13 rotavirus-shedding children were found to have diarrhea compared to 4(30.81.) who had not. The incidence of rotavirus-associated diarrhea in this study was found to be highest in infants aged 1/2-2 years (1 21.) and also was high in infants less than si:-: months ( 101.) , o,Jh i 1 e it was less (5.51.) in children aged 2-4 years. The asymptomatic rotavirus excretors on the other hand were found to be mostly in the age group 2-4 years (5.51.), then in infants less than six months (51.), and chi 1 dren 1/2-2 years (41.) . None of symptomatic or asymptomatic rotavirus excretors were found in the age group 4-6 years. The isolation rates of EPEC and shigella in the stools of diarrheal cases were found to be 5 and 11. respectively, while salmonella and Campylobacter iejuni were not encountered. enteropathogens are This means t.hat the classical no longer the main causes of today, and that neli’Jer infectious diarrhea enteropathogens such as:enterotoxigenic, enteroadherent and enterohemorrhag E.coli, Aeromonas hydrophila and Clostridium difficile may play a more important role in the etiology of diarrhea.