The role of coccidian parasites in the pathogenesis of watery diarrhea was studied among children with protein energy malnutrition (PEM), immunocompromised due to causes other than PEM and immunocompetent diarrheic of matched age and sex, as controls. The results showed that the prevalence of infection was 15.48%, Cryptosporidium was the most prevalent and showed 14.19% (18.3%, 17.5% and 7.3% in PEM, immunocompromised and immunocompetent cases respectively). Cyclospora oocysts were detected only among 2 cases (1.29%) of PEM group. Isospora oocysts were not detected in any of the studied groups. Modified Ziehl-Neelsen (Z.N.) technique was found to be the most reliable technique for identification of coccidian protozoa infection in stool. Giardia lamblia cysts were found in 10.97% and Entamoeba histolytica in 5.16% of cases. Mixed infection (G. lamblia and E. histolytica) was found in 2.58% of the cases. The duration of diarrhoea was more prolonged in Cryptosporidium and Cyclospora infections among PEM and immunocompromised cases. Cryptosporidium is one of the important casuses of watery diarrhoea in infants and children in PEM and immunocompromised patients. Therefore, it is indicated to use modified Z.N. technique as a routine test for stool examination and immunocompromised patients must avoid contaminated water.
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