Viral, Bacterial and Parasitic Etiology of Pediatric Diarrhea in Gaza, Palestine

Objectives: To determine the etiology of acute diarrhea in Palestinian children under 5 years of age and to improve knowledge of the etiology of gastrointestinal pathogens using traditional and molecular diagnostic techniques. Materials and Methods: Various common enteropathogens (viral, bacterial and parasites) associated with diarrhea were investigated by conventional and molecular techniques (PCR) in 150 children less than 5 years of age admitted to the Central Pediatric Hospital, Gaza Strip, Palestine. Results: The occurrence of enteropathogens identified was as follows: rotavirus 42/150 (28%), Entamoeba histolytica/dispar 23/150 (15%), Shigella spp. 9/150 (6%), Campylobacter coli/jejuni and Escherichia coli O157:H7 7/150 (5%) each, Salmonella spp. 3/150 (2%), Giardia intestinalis 1/150 (1%), and Strongyloides stercoralis 1/150 (1%) of the samples. Shigella and Salmonella isolates were tested for their susceptibility to common antimicrobial agents and most of the isolates were resistant to ampicillin and trimethoprim/sulfamethoxazole. Conclusion: This study demonstrated that rotavirus, E. coli O157:H7 and Campylobacter, which are not routinely screened for in Gaza Strip, were significant enteropathogens. The results highlight the value of using a combination of traditional and PCR techniques in the diagnosis of enteropathogens related to gastroenteritis.