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We performed a case-control study of diarrhoea to determine its causes in children Salmonella , Shigella , Campylobacter and vibrios by standard techniques; rotavirus (RV) was identified by polyacrylamide gel electrophoresis; and specific deoxyribonucleic acid probes were used to identify Escherichia coli containing genes coding for Shiga-like toxin I and II, enteropathogenic E. coli adherence factor, and enteroinvasive E. coli (EIEC). E. coli isolates were tested for heat-labile toxin (LT) and heat-stable toxin (ST) production and mannose-resistant adherence to HeLa cells. Rotavirus was identified in 13 of 174 children with diarrhoea (cases) and in 2% of 174 age-matched children without diarrhoea (controls), P C. jejuni was identified in 10% of cases and 2% of controls, P = 0·003. Giardia lamblia was identified in 4 cases, LT and ST enterotoxigenic E. coli (ETEC) in 2, and S. flexneri in 1 case; they were not found in controls. ETEC that produced LT only was isolated from 5 cases and 3 controls, P = 0·721; E. coli that adhered to HeLa cells in a diffuse pattern was isolated from 30 cases and 40 controls, P = 0·229; and E. coli that adhered in an aggregative pattern was isolated from 20 cases and 18 controls, P = 0·863. EIEC was not isolated from cases or controls. Nine cases (5%) developed persistent diarrhoea (>14 d duration). C. jejuni and aggregative E. coli were isolated from different children with persistent diarrhoea. E. coli (serogroup 0119), adherence factor positive, which adhered to HeLa cells in a localized pattern, was isolated from 1 control. Rotavirus and C. jejuni were the most common causes of diarrhoea in children