Irregular dietary habits as a predictor of stunting occurrence among children under 5 years of age:a literature review

Objective:To identify the illustration of feeding patterns of stunting children using literature review method.Methods:This study was a descriptive narrative research using literature review approach to explore dietary habits of children with stunting problem.All the literature review processes employed Guideline Review measurement of Joanna Briggs Institute.Related ar ticles in literature were obtained from journal databases,such as Pub Med,Science Direct,Google Scholar,and Dimensions through structured research question with Patient,Exposure an interest,Outcome or response(PEO)methods.Results:This study found 2246 published ar ticles from 2018 to 2021 about children with stunting.Screening process was conducted fur ther to eliminate ar ticles with irrelevant titles and abstracts,and also the unsuitable ar ticles with the research question;hence,about 9 ar ticles were eligible to be reviewed ahead.All these ar ticles mentioned that children with irregular dietary habits would likely experience stunting.The low intake of nutritional food became the major predictor of stunting.Conclusions:Inappropriate feeding patterns and the variety of food were being the factors of stunting emergence among children<5 years of age.High consumption of carbohydrates,less animal-based protein,and misunderstanding about intake of sweetenedcondensed milk predisposed children to suffer stunting.

Identifying genomic regions controlling ratoon stunting disease resistance in sugarcane(Saccharum spp.) clonal F_(1) population

The ratoon stunting disease (RSD) of sugarcane,caused by the bacterium Leifsonia xyli subsp.xyli,is one of the major concerns to sugarcane production and breeding programs worldwide.Due to no obvious external symptoms,RSD cannot be easily detected by the growers,hence has reduced the world’s sugarcane production significantly.This study aimed to identify quantitative trait loci (QTL) associated with RSD resistance and to assist in the development of linked molecular markers for marker-assisted breeding to minimize the reduction in sugarcane yield by the RSD infection.A set of 146 individuals derived from a self-crossing of CP80-1827 were evaluated for RSD resistance in a mechanically duplicated inoculated field trial from 2014 to 2017 using tissue blot immunoassay.Leveraging the genetic data and the four years phenotyping data of CP80-1827 selfing population,linkage map construction and QTL analysis were conducted based on clonal F_1 and F_2 mapping population types with GACD V.1.2 and Ici Mapping V.3.3,respectively.A total of 23 QTL associated with RSD resistance were identified,which explained 6%to13%of the phenotypic variation with the two types of software.A total of 82 disease resistance genes were identified by searching these 23 QTL regions on their corresponding regions on the Sorghum bicolor genome (44 genes),sugarcane R570 genome (20 genes),and S.spontaneum genome (18 genes),respectively.Compared with Ici Mapping V.3.3,GACD V.1.2 identified more major (6 vs.3) and stable QTL (2vs.0),and more disease resistance genes (51 vs.31),indicating GACD V.1.2 (clonal F_1 mapping type) is most likely to be more efficient than Ici Mapping (F_2 mapping type) for QTL analysis of a sefling population or clonal F_1 population in clonal species.The identified QTL controlling RSD resistance along with the associated SNP markers will assist sugarcane molecular breeding programs in combating this disease.

Detection of Ratoon Stunting Disease in Virus-free Seedcane via Real-time Fluorescence Quantitative PCR

This study was to develop the real-time fluorescence quantitative PCR technique for detecting the ratoon stunting disease （RSD） in virus-free seedcane seedlings. Healthy tissue culture seedlings were obtained from six plants of sugarcane ROC22, which had been confirmed RSD-positive by detecting the sugarcane juice, by employing the sugarcane seedlings production protocol. Real-time fluorescence quantitative PCR was used to detect RSD pathogens in tissue culture sam- pies. The results showed that target fragment of RSD pathogens was not found in all 10 samples in real-time fluorescence quantitative PCR, with the Ct values of 37 - 39. The healthy tissue culture sugarcane seedlings do not carry RSD pathogens, indicating that adopting healthy seedcane seedlings production technique could thoroughly get rid of RSD pathogens.

Addressing Communications Campaign Development Challenges to Reduce Stunting in Indonesia

One in four children under 5 years of age in the developing world are stunted (chronically malnourished). Reducing stunting can be a challenge, especially in populous countries where families are dispersed, as is the case in Indonesia. This paper describes how one government project (Indonesia’s National Nutrition Communication Campaign [NNCC]) delivered effective behavior change communications interventions that reached 40 million people. This paper focuses on four challenges that nutrition campaigns often face and provides useful lessons for similar campaigns, based on the experience of NNCC, which include the following: 1) Fully engaging stakeholders at all levels in campaign design and implementation ensured broad-based support for stunting reduction efforts;2) Pro-actively involving journalists in nutrition campaigns improved public opinion about stunting and positively influenced decision-making in policy formulation;3) Use of humorous public service announcements with limited technical information was effective in engaging priority populations;and 4) Social media (YouTube ads, web advertorials, Facebook pages, Twitter, Instagram) extended the campaign’s reach and reinforced messaging from other sources. Based on NNCC’s experience, specific recommendations are provided.

Stunting-Related Knowledge: Exploring Sources of and Factors Associated with Accessing Stunting-Related Knowledge among Mothers in Rural Indonesia

Background: Stunting in young children continues to be a major concern in developing country settings, including middle income countries like Indonesia. Early intervention is critical to prevent increased morbidity and mortality, lower cognitive functioning, and diminished productivity in adulthood. Mothers may benefit from knowledge and information related to stunting causes and effects. Indonesia has readily adopted a variety of platforms, which are now being used to disseminate health information. The purpose of this study was to address two related research questions: 1) What are the primary sources of Indonesian mothers’ stunting-related knowledge? 2) What factors are associated with using these various platforms to access stunting-related information? Method: Mothers (n = 745) responded to questions about demographics and the source of stunting knowledge, which included hospitals, the Internet, midwives, posyandu (community health posts), and puskesmas (public health centers). Multivariate logistic regression was used to identify factors associated with mothers’ reported use of the three most common sources to acquire information about stunting, including posyandu, puskesmas and the Internet. Results: Eighty percent of mothers in this study sample used posyandu, 31.7% puskesmas, and 16.9% used the Internet as a source for stunting-related knowledge. For the three most common sources, factors associated with each included not accessing the other sources. Conclusions: Indonesian mothers are using a variety of platforms and services to acquire information about stunting. These sources are different one from another and each may be an important resource for disseminating health information, especially outside of urban centers. Results from this study may help to identify characteristics of Indonesian mothers who could benefit from acquiring stunting-related information in these formats. Each of these sources of information appears to be utilized by different groups of mothers. This is an important finding as it suggests that each may continue to be a resource for mothers that might not otherwise access stunting information. The Indonesian health system in rural settings has a history of support for posyandu and puskesmas. Moving forward, the Internet may also be used to improve outcomes for children of mothers that do not access information through these more traditional means.

Molecular Detection of Sugarcane Ratoon Stunting Disease in Hainan Sugarcane-growing Areas

[Objective]The paper was to clarify the occurrence of sugarcane ratoon stunting disease(RSD)in Hainan sugarcane-growing areas.[Method]In 2019,270 samples of sugarcane leaves were collected from six main sugarcane-growing areas in Hainan Province,and RSD was detected by PCR assay with specific primers.[Result]RSD was detected out in 41 out of 270 sugarcane samples,with an average detection rate of15.19%.The detection rates of RSD were different in six sugarcane-growing areas;the detection rate of RSD in Danzhou sugarcane-growing area was the highest of 22.00%;the detection rate of RSD in Lingao sugarcane-growing area was the lowest of 9.26%.RSD was detected out in 8 out of10 main sugarcane cultivars,among which Xintaitang 22 suffered the heaviest damage,with the positive detection rate of 45.83%;RSD had not been detected out in Zhongtang 1 and Zhongtang 2,while the positive detection rates of RSD in the remaining seven sugarcane cultivars were10.00%-31.25%.[Conclusion]RSD commonly occurs in Hainan sugarcane-growing areas.The research results provide a basis for scientific prevention and control of RSD and promotion and application of healthy virus-free sugarcane seedlings.

Nutritional Intervention at a Girl’s Orphanage in Sri Lanka Decreased Stunting after One Year

Background: Both the civil war in 1998 and the tsunami in 2004 in Sri Lanka resulted in a large number of orphans. Objective: To examine the effect of nutritional intervention on one-year period of stunting and/or emaciated status. Methods: Study setting: Twenty-eight girls aged 5 - 19 years old were in the care of Grace Girls’ Home, an orphanage for girls located in the port town of Trincomalee, Sri Lanka, at the time of the survey. Nineteen of them had two available anthropometric measurements recorded over one year of follow-up. Anthropometric measurements were obtained prior to the intervention of nutritional mentoring to the local caregivers, and one year after intervention. Height-for-age, weight-for-age, and BMI-for-age z-scores were calculated using SMART methodology. Nutritional consultancy recommended an additional 15 - 20 grams of high quality protein per day, which was given to the girls. The kitchen team was encouraged to regularly prepare a variety of pulse-based dishes, using local foods and recipes. The local palm oil, rich in saturated fatty acids, was replaced with sunflower oil, rich in polyunsaturated fatty acids. Results: Stunting was decreased from Height to age Z-score (−1.19 ± 0.94) to (−0.90 ± 1.06) (P = 0.016), and BMI Z-score from (−0.80 ± 0.79) to (−0.50 ± 0.74) (P = 0.004). Conclusions: A single nutritional education intervention, culturally adapted and implemented by the local caregivers, can decrease stunting in orphans within one year.

The Prevalence and Determinants of Stunting among Children 6 - 59 Months of Age in One of the Sub-Counties in the Rwenzori Sub-Region, Western Uganda

Introduction: Despite being referred to as one of the country’s “food baskets”, 41% of children, 6 - 59 months of age in the Rwenzori sub-region, Western Uganda are stunted. Stunting is a form of chronic malnutrition in which children are short for their age. In this study, we established the prevalence and determinants of stunting in one of the sub-counties in this region. Methods: This was a cross-sectional descriptive study conducted in one of the sub-counties in the Rwenzori sub-region, Western Uganda from May 26th to June 26th, 2018. A total of 372 mothers and their children were recruited using systematic sampling. Data was collected using a questionnaire. Stunting was determined by taking child’s height or length and comparing it with child’s age. A child whose height or length for age index was less than &#8722;2 Standard Deviations (SD) was considered stunted. We used descriptive statistics to understand characteristics of mothers and multivariable logistic regression model to obtain the determinants of stunting. Data was analyzed using SPSS version 20. Results: A total of 372 mothers and their children were included in this study;majority, 307 (83.0%) of the children were 6 - 24 months old and nearly half, 167 (44.9%) were stunted. We found that reserving food stock for use in the dry season (aOR = 0.23, CI = 0.08 - 0.62, p = 0.004), deworming children (aOR = 0.32, CI = 0.18 - 0.54, p = 0.001) and the family earning at least 10,000 Ushs (2.7USD) at the end of the month (aOR = 0.36, CI = 0.22 - 0.58, P = 0.001) were associated with no stunting. Conclusions: We found a high prevalence of stunting among children 6 - 59 months of age. We recommend enforcing ownership of food granary by households especially during dry season, support to de-worming programs targeting children below five years of age and establishing community based income generating livelihood projects.

Effective Use of Near Real-time Monitoring System for Stunting Reduction in Zimbabwe

Background:In Zimbabwe,26.2 percent of children under five are stunted.Evidence has shown that multi-sector interventions are key to addressing stunting.Yet,practical implementation is difficult,often occurring through separate disjointed and uncoordinated sector actions with limited access to real time information for decision-making.Objective:To describe the design,implementation,successes,challenges and lessons learned from using a near-real time monitoring(NRTM)system as a monitoring tool for multi-sectoral community based model for stunting reduction in Zimbabwe.Methods:An open source technology was used to obtain the information needed on the multi-sectoral coordination process,provide a common platform to capture and present data on situational factors,community conditions and practices to be acted upon and thus contribute to reducing stunting.Results:Significant improvements in community data flows were noted;the system brought together several types of data,concepts,stakeholders and multi-sector energies into focused programming.Several challenges including conceptual issues,initial coordination,financial resources and missed partnership opportunities were documented.The introduction of the NRTM system resulted in improved data flows for programme monitoring and facilitated multi-sector collaboration.Conclusion:NRTM is an effective monitoring tool for the multi-sectoral community based model to reduce stunting in Zimbabwe.

The Relationship of Psychosocial Dysfunction and Stunting of Adolescents in Suburban, Indonesia

The purpose of this study was to investigate the psychosocial dysfunction of adolescents with stunted and normal height. This was a cross-sectional study using pediatric symptom checklist-17 (PSC-17), subjected to adolescents (age: 11 to 14 years) in Suburban, West Java Indonesia. Two variables of the subjects’ characteristics (sex and body height) were included in the multivariate analysis because the p was <0.25 (p = 0.22, p = 0.07). It was found that 53 subjects had psychosocial dysfunction (25 stunted, 4 severely stunted, and 24 normal heights) with significant comparing proportion between severely stunted and normal height (p = 0.04). In severely stunted adolescents, the risk of psychosocial dysfunction is 6.33 more than in normal stature group. Examination was done on those 53 adolescents resulted in several psychosocial disorders: 12 psychosocially low self-esteem, 12 family problems, and others ranging from other several aspect problems. Forty-one from the 53 adolescents were with psychopathology symptoms. There was psychosocial dysfunction just in adolescents with severely stunted.

Height and body mass index trajectories from 1975 to 2015 and prevalence of stunting,underweight and obesity in 2016 among children in Chinese cities:findings from five rounds of a national survey

Background A more comprehensive assessment of growth and nutrition in children is required in China due to rapid socioeconomic processes.We aimed to investigate height and body mass index(BMI)trajectories from 1975 to 2015 and the prevalence of stunting and obesity in 2016 among children in Chinese cities.Methods A total of 904,263 children from birth to 6.9 years were collected from a series of nationally representative surveys in China.Height and BMI trajectories and prevalence of stunting,underweight,overweight and obesity were assessed.Results The average height level of Chinese urban children under 7 years presented a positive secular trend from 1975 to 2015;however,a slowing tendency occurred in 2005‒2015.An apparent increase was observed at the 5th,50th and 95th percentiles of BMI in urban children aged 3 years and older,with a more prominent increase at the 95th percentile.The total prevalence of stunting and underweight under 7 years was 1.4%and 2.0%,respectively.The total prevalence of overweight and obesity under 7 years was 12.6%and 4.3%,respectively,with 12.7%and 4.9%for boys,12.6%and 3.6%for girls,12.1%and 4.0%in urban areas and 13.1%and 4.5%in suburban rural areas.Conclusions The average height level of Chinese urban children has reached World Health Organization child growth standards since 2005 and presented a slowing tendency in secular trend in 2005‒2015.More attention and efforts and public health interventions should be urgently made to combat overweight and obesity among preschool children.

The impact of the Rural Minimum Living Standard Guarantee(Rural Dibao)Program on child nutrition outcomes

The Rural Minimum Living Standard Guarantee(Rural Dibao)is an important unconditional cash transfer program to alleviate poverty in rural China.Despite the importance of children’s nutrition in breaking poverty cycles,little is known about the impact of Rural Dibao on child nutrition outcomes.Using China Family Panel Studies(CFPS),this paper examines the effects of Rural Dibao on child nutrition outcomes and investigates potential pathways and heterogeneous effects.We exploit propensity score matching and difference-in-differences techniques to evaluate the effects of the Rural Dibao program on child nutrition outcomes.Our results suggest that Rural Dibao significantly impacts the nutrition outcomes of children up to 15 years of age.Specifically,our results suggest that Rural Dibao improves child height-to-age z-scores by 1.05 standard deviations and lowers the probability of stunting by 11.9 percentage points.Additional analyses suggest that increased protein intake is the main pathway through which Rural Dibao participation contributes to better nutrition outcomes.We also find that the effect of the program is more pronounced among girls,children who are non-left-behind or live with highly educated mothers,and those from low-income families and poor areas.Our findings suggest that Rural Dibao participation helps improve child nutrition outcomes through improving diet quality.

The Effects of Different Feeding Practices on the Nutritional Status of Infants below 12 Months Old in the Kumba 1 Sub-Division

Appropriate feeding practices are important during infancy for good health, growth and development of infants and children. WHO revised its earlier recommendation of Exclusive Breastfeeding (EBF) of infants from 4 to 6 months of age to EBF until about 6 months of age, with the addition of complementary foods thereafter. This recommendation confirms that breast milk alone is sufficient to meet infants’ nutritional requirements for the first 6 months of life. The main objective of this study was to investigate the effect of various feeding practices on the Nutritional status of infants 0 - 12-month-old in the Kumba 1 Sub-Division. A descriptive cross-sectional study was conducted from December 2019 to August 2020. A total of 341 nursing mothers and their infants 0 - 12 months of age were recruited. Socio-demographic factors and the different feeding habits of the children were assessed using a semi-structured questionnaire. Nutritional status was assessed using anthropometric measurements. The overall proportion of infants who exclusively breastfed for 6 months was 69.2% and those who were mix-fed were 30.8% in the study area. The overall prevalence of malnutrition in the population was 61.0%. Among the malnourished children, 53.1% were underweight, 19.6% were wasted and 10.0% were stunted. Though not significant, the prevalence of wasting (21.0%) and underweight (58.3%) was higher among Mix-Fed (MF) children when compared to their EBF counterparts. Feeding practices affected the nutritional status of the infants. Underweight and wasting were observed among infants on Complementary Feeding (CF), although some exclusively breast-fed infants were stunted. Hence, nursing mothers should try as much as possible to practice EBF as recommended by WHO and can practice CF when the child is above six months.

Nutritional Status of Children during and post-Global Economic Crisis in China

Objective To describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis.Methods Data from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System.Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites.Anthropometric and hemoglobin measurements for children under 5 were conducted.Nutritional status was determined according to WHO child growth standards.Results Prevalence of underweight and stunting in children under 5 had a downward trend.Underweight prevalence was close to normal （less than 5%）,with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas.Prevalence of stunting in infants under 6 months and 6‐12 months old in poorer rural areas increased from 5.7%‐9.1% and 6.7%‐12.5%,respectively,in 2008‐2009.This trend also continued post‐crisis in 2010.Prevalence of stunting in children left behind by mothers was 20%‐30% higher than in children the same age in general and poorer rural areas.Prevalence of anemia in children did not change in rural areas,but prevalence of anemia in all age groups increased in poorer rural areas,especially in children under 24 months old.Level reached 30%‐40% in 2009,and fluctuated in 2010.Conclusion The nutritional status of children under 5 was comparatively stable during and after the global economic crisis,attributable to the Chinese government＇s policy response.The nutritional status in poorer rural areas fluctuated in response to the economic crisis and,thus,relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas.A proper national nutritional strategy for children under 2 years old,including nutrition supplementation for pregnant women and in‐home fortification for complementary feeding,should be initiated.

一种面向物联网的M2M通信解决方案

在分析了M2M系统体系结构和工作原理的基础上,利用NAT穿越技术在物联网中的应用优势,提出了一种基于STUN和STUNT协议的、具有用户身份认证功能的M2M通信方案.经过实验测试,该方案不需要改变原有网络结构,只需要在M2M设备中嵌入STUN Client和STUNT Client模块,就能够实现物联网中不同M2M节点之间的通信与管理.

Malnutrition Prevalence in Lasa Xizang Children and Adolescents

Objective To assess the prevalence of malnutrition among children and adolescents in Xizang （Tibet）. Methods We analyzed data from the Chinese National Survey on Students＇ Constitution and Health for the years 1995, 2000, 2005, and 2010 pertaining to Tibetan children and adolescents in Lase （Lhasa）, aged 7-18 years old. Numbers of survey subjects for these years were：2 393, 2 754, 2 397, and 2 643, respectively. Results Our results indicated that the rate of occurrence of stunting in Tibet has evidenced a gradual decline：for boys, from 26.8%in 2000 to 9.3%in 2010;and for girls, from 25.8%in 2000 to 10.8%in 2010. In general, the wasting rate for both boys and girls in Tibet has gradually decreased over time：for boys, from 17.7%in 1995 to 4.6%in 2005;and for girls from 12.5%in 1995 to 2.3%in 2005. The stunting rates of boys aged 7-13 years old and of girls aged 7-11 years old were 67.5%and 53.1%, respectively, while these rates for boys aged 14-18 years old and girls aged 12-18 years old were 32.5%and 46.9%, respectively. Conclusion Stunting and wasting rates of Tibetan children and adolescents indicate a gradual declining trend over time. The stunting rates of both boys and girls during early puberty were significantly higher than those during late puberty.

Nutrition in Chinese-Korean Children and Adolescents

Objective To study the nutrition habits among Chinese-Korean children and adolescents in Yanbian Autonomous Prefecture, Jilin, China. Methods Data were obtained from the Chinese National Survey on Students＇ Constitution and Health in 1995, 2000, 2005, and 2010 for Chinese-Korean children and adolescents aged 7-18 years. The number of the subjects included was 4789, 4704, 5875, and 5315, respectively. Results The rate of the occurrence of stunting showed a declining trend from 1995 to 2010 （for boys： urban, 6.3%; rural, 12.7% in 1995 and 3.5% for both in 2010. For girls： urban, 7.8%; rural, 13.4% in 1995 and 4.2% and 5.5%, respectively, in 2010）. Although the ratio of wasting did not show significant differences between the urban and rural children and adolescents in 1995, 2000, 2005, and 2010 respectively, the ratio of occurrence of overweight or obesity increased （for boys： urban, 7.3% and 1.3% in 1995, 17.6% and 12.9% in 2010; rural, 7.0% and 1.3% in 1995, 14.6% and 12.8% in 2010, respectively. For girls： urban, 8.1% and 1.0% in 1995, 17.3% and 8.6% in 2010; rural 5.7% and 0.7% in 1995, 16.4% and 7.4% in 2010, respectively）. Conclusion The ratio of malnutrition in children and adolescents in Chinese-Korean areas declined from 1995 to 2010, and the distinction in malnutrition between the urban and rural areas was negligible in 2010. Further, the ratio of overweight and obesity increased over this period.

Application of the WHO Growth Reference (2007) to Assess the Nutritional Status of Children in China

Objective To assess the nutrition status of children and adolescents in China using the WHO growth reference （2007） in comparison with that defined by the International Obesity Task Force （IOTF） and the Working Group on Obesity in China （WGOC）. Methods Overweight and obesity were defined by age-, sex-, specific BMI reference developed by WHO （2007）, IOTF （2000）, and WGOC （2004）, respectively. Stunting and thinness were defined as height and BMI less than two standard deviations （SD） of the WHO growth reference （2007）, respectively. Data of children and adolescents aged 5 to 19 years （n=54 857, 28 273 boys, 26 584 girls） from the 2002 China National Nutrition and Health Survey （CNNHS） were used in the study. Results The prevalence of overweight, obesity, stunting and thinness among Chinese children and adolescents aged 5-19 years was 5.0%, 1.2%, 13.8%, and 7.4%, respectively when the WHO growth reference （2007） was used, whereas the estimated absolute total number affected by these 4 conditions were 14.6, 3.7, 40.6, and 21.8 million, respectively. The prevalence of overweight and obesity was 18.1% in large cities, while the stunting prevalence was 25.1% in rural 4. Obesity prevalence assessed by the WHO growth reference was higher than that as assessed by the IOTF reference, and obesity prevalence assessed by the WGOC reference was lower than that as assessed by the IOTF reference. Conclusion The nutritional status of children and adolescents is not equal in different areas of China. Stunting is still the main health problem of the poor, while overweight and obesity are the main health problems in large cities.

自我测试运动作为素材与教材

ｓｔｕｎｔｓ实为一种力的自我测试运动，它来自于南美的民间游戏。深入的分析与初步的实践证明，它可作为教学课的素材与活动课的教材。与此同时，本文为教材内容的更新，寻找理论依据与操作程式。

Growth retardation and severe anemia in children with Trichuris dysenteric syndrome

Objective: To document epidemiologic data, clinical manifestations and treatment in hospitalized children with Trichuris dysenteric syndrome from Honduras during 2010-2012. Methods: Severe trichuriasis cases were identified by routine stool examinations from hospitalized patients(12 years old or less). Relevant epidemiologic, clinical and management data were obtained from review of clinical histories in the ward. Results: Of 122 Trichuris infections diagnosed in 11 528(1.0%) stool samples for all ages, 81(66.4%) were identified in the age group 2-12 years old, 21(25.9%) of which were severe(≥ 100 eggs in 2 mg of feces). Thirteen of those 21 patients collaborated in this study. Patients(9 males and 4 females) were of rural precedence, from large poor or very poor families, chronically parasitized, and between 2 and 12 years old. Dysentery of months duration, severe anemia and stunting were common complaints; clinical characteristics associated with heavy Trichuris infections included egg counts from 232-3 520 eggs per direct smear, hemoglobin from 3.4-10.8 g/d L, eosinophilia up to 43%, severe malnutrition and growth stunting. Orally administered drugs mebendazole, albendazole, metronidazole, nitaxozanide, and piperazine were prescribed at different dosages and duration other than recommended; no cure or egg excretion control was exercised before patient release. A range of 340 to about 10 000 worms were recovered after treatment from 8 patients. Conclusions: This report underlines the need for detailed community studies in trichuriasis morbidity, effective treatment assessment and clinical response in severely malnourished parasitized children.