1. Detection of Adenovirus,
Astrovirus, Norwalk Virus
and Rotavirus in Libyan
Children with Diarrhea.
Amal Rahouma, Ezzedin Franka, Zaineb Krema,
Khalid Treesh, Omar Abusnena, John Klena and
Khalifa Sifaw Ghenghesh
Departments of Microbiology and Immunlogy and Family
and Community Health, Faculty of Medicine, Tripoli
University, Al-Jala Children Hospital, Tripoli-Libya, and
NAMRU3, Cairo-Egypt

2. Introduction
• Viral agents are an important cause of diarrhea
worldwide, which accounts for several million
deaths each year with children under five years of
age in developing countries being most often
affected.
• The World Health Organization estimated that
diarrhea accounts for 1.6–2.5 million deaths
annually and that each child in the developing world
experiences an average of three episodes of diarrhea
per year.

3. Common Viral Agents Associated with Diarrhea
• Rotavirus
–
–
–
Double-stranded RNA virus.
Species: A, B, C, D, E, F & G
Leading single cause of severe diarrhoea among infants and
young children.
– Nosocomial gastroenteritis
• Adenoviruses
– Non-enveloped icosahedral viruses composed of a
nucleocapsid and a double-stranded linear DNA genome.
– Over 52 different serotypes in humans.
– Most infections with adenovirus result in infections of the
upper respiratory tract.
– Adenoviruses can also cause gastroenteritis (stomach flu).

4. Viral Agents Associated with Diarrhea
•• Astrovirus
Astrovirus
– Non-enveloped single stranded RNA genome.
– Non-enveloped single stranded RNA genome.
– A newly recognized cause of gastroenteritis in children and
– A newly recognized cause of gastroenteritis in children and
adults.
adults.
– Several species that affect mammals with many serotypes
– Several species that affect mammals with many serotypes
within human astrovirus species.
within human astrovirus species.
•• Norovirus (formerly Norwalk virus)
Norovirus (formerly Norwalk virus)
– Non-enveloped single stranded RNA viruses.
– Non-enveloped single stranded RNA viruses.
– Highly infectious associated acute gastroenteritis (winter
– Highly infectious associated acute gastroenteritis (winter
vomiting diseases) and foodborne outbreaks.
vomiting diseases) and foodborne outbreaks.
– Nosocomial gastroenteritis. .
– Nosocomial gastroenteritis

5. Adenovirus

6. Astrovirus

7. Rotavirus

8. Norovirus

9. Aim of the Study
• To determine the prevalence of rotavirus,
adenovirus, norovirus and astrovirus
associated with children diarrhea in Tripoli,
Libya.

10. Materials and Methods
• Study subjects:
– Included in the study 88 children (38 females) aged a few
days to 5 years.
– Diarrhea was defined as the occurrence of three or more
watery stools in a period of 24 hours.
– Parents (or care-providers) of all patients were informed of
the purpose of the study and their consent was obtained
before stool samples were collected.
• Stool samples were collected in sterile containers, and
were frozen at -20 ̊C.
• The study was carried out between February-June
2008.

11. Materials and Methods
• Rotavirus, adenovirus, astrovirus and norovirus
were detected in faecal samples by specific
commercial enzyme-immunoassay [EIA] kits.
• The tests were performed according to the
manufacturer recommendations.

12. Results
• Of the 88 stool specimens examined enteric viruses
were detected in 48.8% (43/88) of diarrheic
children.
• The different enteric viruses detected in the present
study are shown in Table.
• Gender and age had no significant influence on the
detection rates of the examined enteric viruses in
the population studied.

13. Viral Agents of Children Diarrhea in
Tripoli-Libya
Agent
No. ( %) Positive
(n=88)
----------------------------------------------------------• Rotavirus
19 (21.6%)
• Adenovirus
9 (10.2%)
• Astrovirus
3 (3.4%)
• Norowalk virus
12 (13.6%)
----------------------------------------------------------43 (48.8%)
• Total

14. Conclusion
• The present work has clearly demonstrated
that adenovirus, Norwalk virus, rotavirus
and, to a lesser extent, astrovirus are
important causative agents of diarrhea in
Libyan children.
• In the future, studies are needed on larger
groups of patients from major cities in Libya
to determine the exact role of these viruses
in children diarrhea in the country.