Reviewed by Josefien Van Olmen            

An extremely valuable article, rare in its kind and underscoring the relevance of the point of Van Weel in the Lancet, that public health and clinical health are intrinsically linked ( This paper discusses the guidelines for management of adults with fever in LIC and is therefore by default relevant (and very recognizable) for all clinicians working in those areas. Since fever is practically to most common cause for people to consult a health service in LIC, this paper discusses one of the most crucial elements of quality of (physical) care. The overdiagnosis of malaria and the lack of reliable and affordable point of care rapid diagnostics to help clinicians are important notions that public health / health system managers should be tackling. The remarks about making a differential diagnosis are pivotal and should be systematically pursued, supervised and supported. Remembering my years in a district hospital in Tanzania, I know all too well that working in these contexts, without only a few diagnostics and medicines at hand, this is difficult exercise to maintain. The cry from clinicians is an urge to public health professionals. The responsibility for good care for people is in the hands of both.


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