The burden of malaria in the developing world has largely been measured in terms of childhood mortality. Annually, 300–500 million infections occur resulting in 1 million deaths; these account for 20% of childhood mortality in malaria endemic regions.¹ An article by Carter et al (this issue, pp 476–81) provides evidence that the burden of malaria includes chronic neurological consequences among survivors.²

The possibility that survivors of severe malaria suffer from neurological sequelae such as cognitive deficits or epilepsy has been suggested.³ Certainly, gross deficits at hospital discharge among a small proportion of survivors have been reported, …