European Journal of Scientific Research - EuroJournals

Aetiology and Epidemiology of Sever Infantile Diarrhoea in Baghdad, Iraq 360
fatal, resulting in the deaths of 5 to 18 million children [3]. A later study in the same areas estimated 3
to 5 billion cases of diarrhea and 5 to 10 million diarrhea-associated deaths in 1 year, ranking diarrhea
first among infectious diseases in the categories of both frequency and mortality, with the burden
greatest in infants and young children [2].
Infant gastroenteritis remains a critical public health problem all over the world as was
recognized by WHO [3] and acute diarrhea due to bacterial infections is one of the main causes of
childhood morbidity and mortality especially in developing countries [4]. Despite the importance of
this disease, the agents of a large proportion of diarrhoeal illnesses of infants and young children were
not known until relatively recently [2].
Up to 70% of the 1400 million episodes of diarrhea worldwide in children under age 5 years
cause this morbidity and mortality may be due to pathogens which is transmitted through food [5] or
drinking water [6].
Among the causative agents, the following bacteria have been reported: Enterotoxigenic
Escherichia coli (ETEC), Shigella, Salmonella, and Campylobacter [7, 8]). Among the viruses,
rotavirus seems to be the most common [9]. Food contamination is one major route for the
transmission of enteropathogens, especially under the hygienic conditions prevailing in a rural setting.
Various studies have reported that the source of the enteropathogens was either water or food [10].
Rotavirus is the leading cause of severe gastroenteritis among children worldwide [11].
Annually rotavirus is estimated to cause 352,000-592,000 deaths, 2 million hospitalizations and 25
million clinic visits globally among children younger than 5 years of age [12], mortality and
hospitalization rates vary significantly depending on access to health care in developing settings.
Depending on the setting and studies, rotavirus was found in 13-71% of diarrhea cases requiring
inpatient or outpatient medical care in infants and young children [13, 14].
Most cases of gastroenteritis have a viral etiology and are self-limited. However, more severe
or prolonged cases of gastroenteritis can result in dehydration with significant morbidity and mortality.
This is often the scenario in third-world countries, where gastroenteritis results in 3 million deaths
annually [15].
The main risk of gastroenteritis in children, particularly babies and young children is that they
become dehydrated. This can occur very quickly in babies because they do not need to lose a lot of
fluid to lose significant percentage of total body fluid [16]. The most effective treatment and
intervention method for acute diarrhea and for the control of diarrhoeal mortality has been the use of
oral rehydration therapy (ORT). The aim of ORT is to restore the initial fluids deficits and to replace
ongoing stool losses until diarrhea ceases [17]. The ORT fluid composition is presented in table (1).
New diagnostic laboratory techniques as well as modifications of standard ones have been used by
investigators to identify viral, bacterial, and parasitic agents of outbreaks of gastroenteritis [18].This
study was designed to determine the causative agents of diarrhoea in children less than 2 year of age in
Baghdad / Iraq and to assess the efficacy and safety of using ORT treatment in management of
infantile diarrhoeal dehydration.