The signs and symptoms of malaria are nonspecific. Malaria is clinically diagnosed mostly on the basis of fever or history of fever. The following WHO recommendations are still considered valid for clinical diagnosis.6
• In general, in settings where the risk of malaria is low, clinical diagnosis of uncomplicated malaria should be based on the degree of exposure to malaria and a history of fever in the previous 3 days with no features of other severe diseases.
• In settings where the risk of malaria is high, clinical diagnosis should be based on a history of fever in the previous 24 h and/or the presence of anaemia, for which pallor of the palms appears to be the most reliable sign in young children.
6 WHO Expert Committee on Malaria. Twentieth report. Geneva, World Health Organization, 2000 (WHO Technical Report Series, No. 892).
The WHO/UNICEF strategy for Integrated Management of Childhood Illness (IMCI)7 has also developed practical algorithms for management of the sick child presenting with fever where there are no facilities for laboratory diagnosis.
7 IMCI information package, 1999. Geneva, World Health Organization, 1999 (document WHO/CHS/ CAH/98.1).