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In Reply: I appreciate Dr Lyman’s concerns. "Jahi" was a long-time staff member at the hotel in Tanzania, and his history of childhood malaria was already known to his employer before I initiated my research for this essay. His employer shared the information in the interest of drawing attention to the worsening scourge of malaria.

In writing this essay, several alterations were made to protect the identity of the individual I described. For example, the name Jahi is a pseudonym. I do not believe that the individual is identifiable based on his medical history. Not only does severe malaria account for 9% of all deaths in Africa every year,¹ 3% to 28% of its survivors have some neurologic sequelae, including chronic neurocognitive deficits.² Sadly, there are many Jahi’s in Africa today.

Financial Disclosures: None reported.

Claire Panosian Dunavan, MD, DTM&H (London)
cpanosian@mednet.ucla.edu
David Geffen School of Medicine at UCLA
Los Angeles, Calif

1. Breman JG, Alilio MS, Mills S. Conquering the intolerable burden of malaria: what’s new, what’s needed: a summary. Am J Trop Med Hyg. 2004;71(suppl 2):1-15. FREE FULL TEXT 2. Mung’Ala-Odera V, Snow RW, Newton CR. The burden of the neurocognitive impairment associated with Plasmodium falciparum malaria in sub-Saharan Africa. Am J Trop Med Hyg. 2004;71(suppl 2):64-70. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;294:680.

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