الفهرس 
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Abstract
Gastroenteritis refers to inflammation of the lining of both the stomach and small intestines. The majority of cases are infectious with viral organisms predominating; however, bacterial and parasitic infections can be a specific concern in the appropriate patient.
Although it can affect individuals of any age, it presents significant health risk to those at extremes of age, the very young and the very old (Jones, 2003).
According to WHO, approximately one billion cases of diarrhea occur each year worldwide causing a burden that was about 99.2 million DALYs lost. It is well known that diarrheal disease is one of the leading causes of illness and death in young children. In developing countries diarrhea accounts for 21% of all diseases causing deaths at below five years of age and causes 2.5 million deaths per year, although diarrhea morbidity remains relatively unchanged, about one billion episodes or 3.2 episodes per child-year (Parashar et al.,2003)
The main route of transmission of enteropathogens is faecal-oral through the ingestion of contaminated food or fluids or by direct person-to-person contact. The factors that increase the transmission of enteropathogens in developing countries include contaminated water and food, poor sanitation and hygiene, lack of breast feeding, malnutrition, deficiencies in micronutrient like zinc or vitamin A, crowded environment, and living close to domestic animals.
Risk factors which was reported sigificantly affecting occurrence of gastroenteritis as family size more than five; bed room sharing among more than three people; irregular hand washing by mothers after going to toilet; no hand washing by mothers before feeding children; unsafe storage of food for later use; repeated URTI; repeated otitis media; repeated GE; poor knowledge of mothers; buying food from street vendors; presence of flies at house; old type of latrines used; un washed vegetables and fruits ; using unfiltered water; uneducated mother and father.
There was a marked negative relationship between diarrhea and physical growth and development of child. Each day of illness due to diarrhea produces a weight deficit of 20-40 grams. The infant who spent more than 20 % of their time with diarrhea had a weight deficit of approximately370 grams at follow-up after 1 year of age (Molbak, 2000).
The study was conducted in Elmofty & Shalma family health units as well as the family health care center of Sedi-Salim city. Which are randomly selected representing the family health care facilities in Sedi-Salim district, Kafer Al-Sheikh Governorate.
Preschool children and their mothers attending the selected sites during the period of the study full filling both inclusion and exclusion criteria. Collection of cases and controls were during the summer and winter seasons and 2days per week. (No: 170 case, 352 control).
Procedure of the study
Both patients and controls were invited after their consent and care givers agreement to participate in the study
They were subjected to:
A- The predesigned questionnaire
B) Complete physical examination with special emphasize on:-• Level of consciousness and activity
• Ability of drinking was assessed by giving cup of water to the child
• Vital signs
• Anthropometric measures
• General examination
• Signs of dehydration
• Head and neck , chest and abdominal examination
Knowledge were considered good if score of related items was> 75% of total score of all items. Fair knowledge 50% _75% of answers were right. Poor knowledge <50% of answers were rights.
There is statistical significant difference between cases and control in (p<0.001) the number of mothers who had good and fair knowledge of causes and symptoms of GE in the control group was higher than that in the case group. On contrary, number of mothers having poor knowledge of diarrhea in the above mentioned case group was higher compared with control group.
There is statistical significant difference between cases and control in(p<0.001) knowledge parameters of mothers about unclean bathroom causes diarrhea, un washed hands causes infection, un washed fruits causes diarrhea, absent flies protect from infected diarrhea, ORS is important for treat diarrhea, repeated URTI causes diarrhea.
There is statistical significant difference between cases and control in ( p<0.001) age, sex, sharing persons in bed room, repeated GE, repeated otitis media, repeated URTI, weight, height, Motor
development, Language development, level of mother’s, father’s education, fathers’ occupation and family number.
There is symptoms of GE among preschool children, where abdominal pain(84.7%), mucus in stool(60.6%), undigested food( 64.7%) and vomiting(64.1%) were the most reported symptom. Cases with Blood in stool were (15.3%) and dysentery were (15.3%). This shows that cases of viral GE more than cases of bacterial GE.
In conclusion, this study identified some possible risk factors of occurrence of gastroenteritis as: Uneducated mother and father, unemployed father and family size more than5. Sharing persons in bed room, repeated GE, repeated otitis media and repeated URTI. Poor knowledge of mothers about causes and symptoms of diarrhea .Old type of latrines used, irregular hand washing after going to bathroom and before preparing food, buying food for the child from street vendors, unsafe storage of food for later use, presence of flies at house, using unfiltered water and unwashed vegetables and fruits
So that we can recommend that encourage mothers to wash their hands with soap, public healthcare workers should pay more attention to effectively inform the population about health and sanitation through mass media to the households, and educational intervention programs for prevention of GE is mandatory in family health units.