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Abstract
A 1-year prospective study in Gaza of diarrhoeal disease in children aged <5 years demonstrated that Salmonella spp. (18·5% of cases), Cryptosporidium (14·6%), Campylobacter spp. (8·3%) and rotavirus (6·8%) were the major pathogens. However, when compared with non-diarrhoeic controls, only Cryptosporidium and rotavirus were significantly associated with diarrhoea. Cryptosporidiosis was found only in children aged <2 years and significantly more children with cryptosporidiosis were malnourished. This malnutrition may have been due to the infection, since children with cryptosporidiosis tended to have had diarrhoea for relatively long periods prior to admission.
It was not possible to distinguish between the different enteropathogens on clinical grounds. However, more children with rotavirus infection vomited and cryptosporidial diarrhoea lasted significantly longer (14·9 days) than rotavirus diarrhoea (5·9 days). Overcrowding was linked with an increased risk of cryptosporidiosis and breast feeding was associated with some protection. Twenty-one of the 29 children who died during the study died with diarrhoea and Cryptosporidium was detected in eight (38%) of these 21 children.