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To the Editor: In response to influenza outbreaks caused by highly pathogenic avian influenza virus (HPAIV) throughout western Africa as of 2006, the National Veterinary Epidemiologic Surveillance Network of Mali (EPIVET-Mali) started conducting domestic and wild bird surveillance. No HPAI outbreaks were reported to the World Organisation for Animal Health. An evaluation survey conducted in 2009 enabled identification and correction of some weaknesses in the organization and functioning of the network (1). However, no attempt was made to assess how much information on bird health in backyard poultry farms (which account for ≈95% of the total poultry population in Mali) actually reached EPIVET-Mali veterinarians and technicians. Therefore, we quantified reporting of clinical signs of avian diseases, especially those suggesting HPAI, by poultry owners in Mali. We used a pilot-tested standardized quantitative and qualitative questionnaire to conduct face-to-face interviews in 32 randomly selected villages in the southern half of Mali (which accounts for 98% of the poultry population). In each village, we conducted interviews in 4 randomly chosen households. No eligibility criteria were used for household selection because all village households had poultry. Interviews were repeated 6 times (approximately every 3 months) during November 2009–February 2011 in the same villages and whenever possible in the same households. If it was not possible to repeat an interview in a previously interviewed household (absence of the household chief), the neighboring household was interviewed. For each household, data were collected on number of sick and dead birds in the previous 3 months, clinical signs observed, and their notification or lack thereof to veterinary authorities. Households in which birds showed >3 of the following clinical signs (diarrhea, respiratory disorder, nervous signs, cyanosis of the combs or wattles, and mortality rate >50%) were considered as having clinical signs suggesting HPAI. The study was approved by the Direction Nationale des Services Veterinaires and traditional authorities in all 32 villages, and oral consent was obtained from the poultry owners before interviews. A total of 110–128 households were investigated at each study interval, depending on village accessibility and presence or absence of household chiefs (Table). We conducted 738 household investigations in 152 households (80 households were interviewed 6 times, 26 five times, 11 four times, 21 three times, 7 two times, and 7 one time). Observation of sick poultry in the 3 months before the interview was reported in 44.6% of household investigations, and observation of signs suggesting HPAI was reported in 12.2% (Table). Notification of veterinary authorities was reported in 13.5% of household investigations with sick poultry and in 17.4% of household investigations with signs suggesting HPAI (Table). Table Observations and reporting of sick poultry and signs of influenza suggesting HPAI virus infection, Mali, 2009–2011* When we considered the 80 households interviewed 6 times, observation of sick poultry and signs suggesting HPAI varied over time (p = 0.043 and p = 0.018, respectively, by Cochran Q test), whereas variation over time could not be tested for notification because of an insufficient number of observations. When we considered all 738 household investigations as independent investigations, observation of sick poultry and signs suggesting HPAI varied over time (p = 0.008 and p