الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Rotavirus (RV) is the most frequent cause of viral gastroenteritis in children under 5 years of age. The virus can cause severe diarrhea and dehydration, especially in children aged 6 to 24 months. In developing countries, acute gastroenteritis due to RV infection (RV AGE) causes the death of approximately 440,000 children every year.
The virus is mainly transmitted by Feco-oral route or by direct contact, but it can occasionally be transmitted through DROPlets. Since the virus is stable in the environment, transmission can occur through the ingestion of contaminated water and food, and through contact with contaminated surfaces and objects. Cross-infection through contamination of the hands is probably the most common transmission route in healthcare settings.
In the temperate zones of the planet, the virus has seasonal peaks (in the Northern hemisphere from November to March), whereas in tropical regions RV infections occur all year round.
The incubation period is 24–72 hours, after which illness can begin abruptly with fever and vomiting often preceding the onset of diarrhoea.
Up to one-third of children will develop a fever of > 39˚C. The illness lasts from three to eight days. Children with rotavirus are infectious during symptoms and until approximately eight days after the onset of symptoms. Large quantities of rotavirus are present in the stool, and few virions are required to cause infection in a susceptible host.
Diarrhea episodes with proven viral etiology (rotavirus) had an entero-toxic clinical appearance:
• Vomiting and frequent watery stools in 90% of children;
• Moderate or high fever;
• Abdominal meteorism;
• Acute dehydration syndrome (ADS) (mild or moderate with an estimated fluid deficit of 3-10% of body weight) in 50% of cases;
• Severe ADS (with an estimated fluid deficit of more than 10% of body weight) in 2% of the cases;
• Alteration of the general status.
Our study was done on 100 infant & child below 5 years of age during the peak of diarrheal season (November – February, of 2011/2012) with or without admission seeking treatment from diarrhea plus 20 healthy infant and child selected as controls that have not experienced acute diarrheal illness during the preceding 30 days .
Cases with diarrhea lasting more than 14 days, diarrhea secondary to other illness, dysentery (gross blood in diarrheal stool) and children with drug history of immuno-suppressive or documented significant back-ground disease such as immuno-deficient syndromes were excluded from our study.
All patients were subjected to full history taking, clinical examination and laboratory investigation: ROTASTICK which is a sensitive and rapid stick test for the detection of rotavirus from fecal samples.
Data was collected, tabulated and statistically analyzed.
The results of this study revealed that:
Rotavirus was detected in 31 % (31/100) of all the fecal specimens examined (P.value 0.019).
The children enrolled in the study were divided into five age groups. The frequency of rotavirus infection varied significantly with age (P.value< 0.05).
Infants below 12 months of age were particularly affected, accounting for 63 cases (63%), followed by 21 cases (21%) in the age group 13-24 months.
The majority of patients who were positive for the virus, 90.3% (27/31), were 0 to 24 months, and the infection rate decreased with increasing age.
Most of rotavirus-positive cases 18/31 (58.1%) were in the age group 0-12, followed by 9/31 (29%) in the age group 13-24.
The highest rate of rotavirus antigen detection was observed among the (13 to 24) months age group since 9 out of the 21 diarrhea cases (42.9%) examined in this age group were positive for rotavirus, followed by the age group (0-12) month (28.6%) and it decreased over age.
The type of feeding had a highly significant role in the protection against rotavirus infection (P.value 0.001).
Clinically; children infected with rotavirus were more likely to have watery stool (96.8%) with statistical significance (P value < 0.006), fever (74.2%), vomiting (93.5%) and moderate dehydration (16.1%).
Slightly more males (59/100) who had diarrhea than females (41/100). The ratio of rotavirus infection, however, was higher in the female subjects, (14/41 of the females and 17/59 of the males) and this difference is statistically significant (P.value< 0.01).
Most of the children 51% (51 of 100) who had diarrhea and were admitted to the hospital came from Defra village, 38% (38 of 100) were from Tanta city and the rest was from other nearby villages. The highest rate of rotavirus antigen detection (31.4%) was observed among the Defra village group.
There was no significant difference in the frequency of infection among patients from urban and rural areas (P.value 0.063).