Recognizing Malaria William Brieger, The Johns Hopkins University 2 November 2007 The first lines in the abstract of this article caught my attention: "Quite often symptoms of malaria go unrecognized or untreated. According to the Multilateral Initiative on Malaria, 70% of the malaria cases that are treated at home are mismanaged. Up to 82% of all malaria episodes in sub-Saharan Africa are treated outside the formal health sector." I disagree that symptoms, especially in children, often go unrecognized and untreated. The challenge from the cultural point of view is the plethora of symptoms that are ascribed to malaria. In addition, the unstated assumption that clinical diagnosis is better than home diagnosis is also not supported, so getting to a health facility without the aid of proper laboratories is still problematic. Finally, the vast majority of parents do seek some form of treatment for their children, although as mentioned, it is often inappropriate. Ultimately the authors' call for interventions to aid timely and appropriate treatment in homes and communities will save lives.Bill Briegerhttp://www.malariafreefuture.org/blog/1. Brieger WR. Pile sorts as a means of improving the quality of survey data: malaria illness symptoms. Health Education Research 1994; 9(2): 257-260.2. Afolabi, BM, Brieger WR, Salako LA. Management of childhood febrile illness prior to clinic attendance in urban Nigeria. Journal of Health, Population and Nutrition. 2004; 22(1):46-51.3. Salako LA, Brieger WR, Afolabi BM, Umeh RE, Agomo PU, Asa S, Adeneye AK, Nwankwo BO, Akinlade CO. Treatment of childhood fevers and other illnesses in three rural Nigerian communities. Tropical Pediatrics 2001; 47: 38-46. Competing interests I declare that I have no competing or conflicting interests either financial or non-financial.