title: Non-bacterial etiologies of diarrheal diseases in Afghanistan.
abstract: BACKGROUND
  Microbial diarrheal diseases are one of the leading causes of child morbidity and mortality in developing countries. This study aimed to identify the main causes of non-bacterial diarrhea in Afghanistan.
  
  
  METHODS
  A total of 699 stools were collected from children aged under 5 years who presented with diarrhea at Indira Gandhi and Kandahar hospitals. Frozen aliquots were preserved for screening against rotavirus, astrovirus, adenovirus, norovirus, Cryptosporidium and Giardia, when bacterial cultures tested negative. Tests were performed at the hospitals after laboratory staff were trained and provided with enzyme-immunoassays and equipment. Results were confirmed at the U.S. Naval Medical Research Unit No. 3, Cairo, Egypt.
  
  
  RESULTS
  Of the samples tested, 71.9% (503/699) were infected with one or more pathogens. However, the majority (85.8%; 432/503) showed single infections: rotavirus (72.2%; 329/432), Cryptosporidium (14.1%; 61/432), Giardia (5.1%; 22/432), astrovirus (2.3%; 10/432), adenovirus (1.6%; 7/432) and norovirus (0.7%; 3/432). The remaining 14% (71/503) showed mixed infections of the tested pathogens.
  
  
  CONCLUSIONS
  Non-bacterial pathogens were identified that could enable health officials to adopt more effective treatment and control measures for diarrhea in Afghanistan.
authors.affiliation: U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt diaa.elyan.eg@med.navy.mil.
authors.forename: Diaa
authors.initials: D
authors.lastname: Elyan
authors.affiliation: U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt.
authors.forename: Momtaz
authors.initials: M
authors.lastname: Wasfy
authors.affiliation: U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt.
authors.forename: Hanan
authors.initials: H
authors.lastname: El Mohammady
authors.affiliation: U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Hassan
authors.affiliation: U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt.
authors.forename: Jesse
authors.initials: J
authors.lastname: Monestersky
authors.affiliation: Afghanistan Public Health Institute (APHI) - Ministry of Public Health (MoPH), Islamic Republic of Afghanistan.
authors.forename: Bashir
authors.initials: B
authors.lastname: Noormal
authors.affiliation: U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt.
authors.forename: Buhari
authors.initials: B
authors.lastname: Oyofo
mesh_terms: D000257:Adenoviridae Infections / Q000453:epidemiology; D000346:Afghanistan / Q000453:epidemiology; D019350:Astroviridae Infections / Q000453:epidemiology; D017250:Caliciviridae Infections / Q000453:epidemiology; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000453:epidemiology; D003967:Diarrhea / Q000469:parasitology* / Q000821:virology*; D005243:Feces / Q000469:parasitology / Q000821:virology; D005260:Female; D005873:Giardiasis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012400:Rotavirus Infections / Q000453:epidemiology
keywords: Afghanistan; Diarrhea; ELISA; Non-bacterial