The pattern of diarrhoeal disease has changed in Karachi over the years. Bacillary dysentry and parasitic infestations were more frequent in the past than in recent years. Shigella (12.4%) was the commonest bacterial pathogen followed by Esch. coli (6.7%) in the series reported by Ingram et al. (1966), while in the present study Kiebsiella and Esch. coli were more frequent. In Bangladesh Esch. coli Enterotoxigemc (ETEC) was mostly isolated enteropathogen followed by Shigella (Black et al., 1981). None of the Esch. coli tested were positive for heat labile toxin (LT) in this study while Reis et al. (1980) found LT in stools of patients and controls and heat stable toxin (ST) only in patients with diarrhoeal symptoms.
Viruses were infrequent in diarrhoeal stools (Park et al., 1966) but now Rotavirus has assumed a considerable importance. The occurrence of Rotavirus diarrhoea was similar in Islamabad (Khan et al., 1982) while in Bangladesh the frequency was greater (Black et al., 1980).
Variances were reported in the age group in children with Rotavirus diarrhoea. In the present series and others (Al Nakib et al., 1980; Khan et al., 1982; Urasawa et al., 1981) more Rotavirus positive cases were reported in children upto one year while Steinmann et al. (1981) reported
Rotavirus in 23.3% of infants below 6 months. Other workers have found the infection to be uncommon in the first six months of life (Gurwith et al., 1981; Hull et aL, 1982; Sengupta et al., 1981; Soeharto et al., 1981).
Seasonal variation regarding rotavirus in-fection was also observed by Al Nakib et al. (1980), Black et al. (1980) and Radda and Kunz (1981), while Suzuki et al. (1981) and Soeharto et al. (1981) found Rotavirus in 21% and 38% respectively in children throughout the year. Rotavirus was also detected in summer and in thy season (Hull et al., 1982; Robins Browne et al., 1980). Giardia lamblia was the only parasite reported in the present study. Pickering et al. (1981) and Monaghan et al. (1980) also found giardiasis to be common in infants and children with diarrhoea.
As the aetiological agents of diarrhoea change with time it is important that such studies should be conducted at various intervals in order to determine the frequency variation of infecting organisms.
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