الفهرس 
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Abstract
A survey on the parasites causing persistent diarrhea in children infected with intestinal protozoa.
In this connection, 300 cases of the stool diarrheic children aging under one year attending the inpatient and outpatient clinics of pediatric department of EL-Minia public hospital were recorded and examined by the following methods:
Direct smear method, sedimentation with physiological saline and znic sulphate centrifugal floatation as well as Sheather’s sugar floatation and Staining with modified zeihl- Neelsen stain.
The incidence of each parasite per total number were estimated and recorded and the prevalence of parasites was estimated according to the locality of its host either in rural or urban areas, sex of the patients, Immunostatus of the patients, type and mode of nutrition of the patients and Seasonal variation.
As a result of the present study, we got the following data:
The prevalence of parasitic infection which could be detected in diarrheic stool sample was 82 % and the prevalence of parasitic infection in rural areas was (96 %), while its prevalence in urban areas was (68 %).
The prevalence of each parasite was as the following:
Entamboea histolytica was found to be the most common parasite among children, and its prevalence was (38 %),Giardia lamblia was (18%),Entamoeba coli was (16 %), Cryptosporidium was (8 %) and Isospara belli was(2 %).
The prevalence of parasitic infection in relation to sex showed that it was (87%) in males and (74.7 %) in female. These results were proved to be statistically not significant and the prevalence of parasitic infection in immunocompetent patients was 19.2 %, 9.6% 9.6%, 2.6 % and 0 %in Entamoeba histolytica, Giardia lamblia ,Entamoeba coli, Cryptosporidium and Isospara belli respectively. While its prevalence in immunosuppressed 69 %, 31.8 %, 26.5 %, 16.8 % and5.3 % respectively. These results were proved to be statistically significant.
It was estimated that the incidence of fed children was (58 %)with breast and was (94 %) in non breast-fed children. These results were proved to be statistically significant.
It was estimated that the incidence of parasitic infection in diarrheic children was (94.2 %),(66.6 %),(83.8 %)and(68.9 %) in winter, spring, summer and Autumn respectively. These results were proved to be statistically significant.
The mean hemoglobin concentration was low in children who were positive for Intestinal protozoan parasites. The higher infection rate suggests the presence of infection from environmental sources and a public health problem. Entamoeba histolytica was the commonest pathogenic parasite followed by Giardia intestinalis and their high infection rate seemed to be associated with lower hemoglobin level. A significant statistical difference in the hemoglobin level concentration was observed only children with Entamoeba histolytica, (t=35.5, p= 0.001) as wall as males infected with Giardia intestinalis (t=29.5, p=0.001).
Increased serum IgE levels are indicators of intestinal parasitic infections. On estimating different immunoglobulin levels IgE, it was found that there was a significant (p=0.001) increase in IgE level in amoebiasis and other parasite while immunoglobulin levels were decreased only in uninfected children.
Tumor necrosis factor-alpha (TNF-α) is a human cytokine involved in inflammatory responses, and although its effect on adult parasites metabolism. Higher levels of TNF-α were associated with significance (p<0.001) in Entamoeba histolytica, Giardia lamblia, Entamoeba coli, Cryptosporidium while no significant increase was observed in (TNF-α) levels in Isospara belli cases compared to negative controls.