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Rotavirus was looked for in stool specimens from 200 randomly chosen infants and children aged 1-24 months presenting with acute diarrhoea of not more than 5 days duration at the Bab El-Sha'reya University Hospital during a 12-month period (January-December 1986). Forty per cent of cases were positive for rotavirus by the ELISA technique. Considering the seasonal pattern, during the hot months May to August, the monthly percentage of rotavirus positive cases ranged from 24 to 32 per cent while during the rest of the year, the range was from 37 to 60 per cent. There was no statistically significant difference between the rotavirus positive and negative cases as regards mean age in months (9.5 +/- 5.1 and 9.2 +/- 5.5, respectively), type of feeding or nutritional status. However, rotavirus positive cases were significantly more likely to present earlier, to have watery stools, to vomit or even to have vomiting before the onset of diarrhoea and to have respiratory symptoms. On the other hand, the means of dehydration score, rectal temperature and serum Na+ were not significantly different between the two groups.

Caretaker recognition of clinical utility of respiratory signs and symptoms in the prediction of pneumonia was examined in a prospective study of infants and children in four cities in Egypt. In all 688 children aged 2 months-5 years presenting with a history and/or physical examination findings of cough and difficult or fast breathing were recruited from out-patient health facilities. The validity of caretaker terms was determined using paediatrician observation of standard respiratory signs and symptoms, x-ray diagnosis and pulse oximetry as standards. The sensitivity of 'nahagan' (Egyptian Arabic for fast breathing) for identifying elevated respiratory rate was 78% +/- 4, and was slightly higher for < 12 month olds (85% +/- 5) versus children aged 1-5 years (74% +/- 5). 'Sedro tale nazel', which describes the chest as moving up and down, was a sensitive (86% +/- 3) and specific (60% +/- 4) indicator of chest indrawing. 'Tazyeek' (wheeze) had a sensitivity of 75% +/- 3 and specificity of 66% +/- 4 when compared to paediatrician assessment of wheezing during physical examination. Although not specific, the caretaker terms, 'nahagan' or 'nafas seria' (fast breathing) and 'sedro tale nazel' (chest indrawing), either spontaneously or after asking, were sensitive (> 71%) indicators of radiologic pneumonia and oxygen desaturation, and therefore can be used to prompt timely health seeking behaviour in these settings.