Severe malaria in West African children [letter]

Olaf Muller and co-workers (Jan 4 p 86) suggest that malnutrition may be a far more important cause of anaemia than malaria in west African children. This is not a trivial issue since it may redirect malaria control efforts toward nutrition programmes. This supposition goes against our clinical experience. In places with seasonal malaria anaemia is more common at the end of the rainy season when malaria is flourishing and food is abundant than at the end of the dry season when malaria is infrequent and malnutrition common. (excerpt)