European Journal of Scientific Research - EuroJournals

367 E. N. Al-kaissi, M. Makki and M. Al- Khoja
No pathogens were isolated for 30.5% of diarrhoeal cases; some of these cases may be caused
by other enteric viruses or parasites which were not investigated.
Discussion and Conclusion
Gastroenteritis in children is a common reason for visits to family physicians. 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. Some
problems still exist in Iraq in educating the public and professional on the new concepts of diarrhoeal
management as oral rehydration and continued feeding. This has been reflected in the presence of a
large number of parents who refused or were reluctant to accept this approach of therapy (Table 4).
Most children with gastroenteritis can be treated with physiologically balanced oral rehydration
solutions [15]. In children who are hypovolemic, lethargic and estimated to be more than 5 percent
dehydrated, initial treatment with intravenous boluses of isotonic saline or Ringer's lactate may be
required. Children with severe diarrhea need nutrition to restore digestive function and, generally, food
should not be withheld [15].
Prevalence of diarrhea during summer season is a common feature of tropical and subtropical
countries and occurred more in infants under one year of age (Figure 1) similar findings were reported
by [26]. Others reported that there is marked seasonal variation in occurrence of infection with peaks of
incidence during summer and autumn [21].
The association of faecal leucocytes with organism known to penetrate intestinal mucosa such
as Shigella species and EPEC was noted in this work. Similar findings were reported by others [27, 28,
and 29], so the importance of direct stool examination of patient with diarrhea was reemphasis in this
work.
The maximum incidence (45%) of gastroenteritis occurs in patients with 7-12 month of age, the
same results were reported by Ballal and Shivanada in 2002[30].
Diarrhea caused by Rotavirus was detected in 29.5% of the diarrhoeal children, the infection
exhibited a marked seasonal distribution, with most of the cases occurring during the summer, and
other similar studies undergone in Basrah (southern part of Iraq) have reported that Rotavirus
admissions and isolation rates were highest during late winter. Khetsuriani, and Parashar reported in
2002[31] that in temperate climates, rotavirus disease predominantly occurs during the fall and winter
months, a study from Japan showed that, unlike in children, rotavirus diarrhea in adults did not show
significant winter seasonality, in the United States, rotavirus activity peaks in the Southwest in autumn
(October through December) and migrates across the continent, peaking in the Northeast during spring
(March through May), in tropical settings, rotavirus disease occurs year-round [31].These may be due
to weather and social differences, most of the salmonella isolated were serotype B, C, or E. infections
with these organisms appeared to occur as isolated outbreaks (Figure 1).
Aetiology of diarrhoeal disease in Baghdad
Results showed that food-borne infections due to Salmonella and Campylobacter are significant. Low
numbers of Salmonella species may also be isolated from the faeces of healthy asymptomatic carriers,
asymptomatic carriage of these organisms is common and they were also important causes of infantile
diarrhea. Salmonella are mainly transmitted via dairy and meet products [32]. Poultry is believed to be
an important reservoir for Campylobacter [33]. Infections with these organisms have been increasingly
prevalent in recent years which coincide with increases poultry production in Baghdad. Rotavirus is the
most common of the enteric pathogens isolated (29.5%), other similar studies [34] have reported that
Rotavirus was detected in 28.5% of diarrhoeal children aged 5 years or under, other investigation in
Basrah by Mahmood and Feachemt in 1987[35], Rotavirus was detected in 24% of cases. As
previously reported the virus population is genetically diverse and varies with time [34]. In the present