FIGURE 1-1 Distribution of Endemic Malaria in Africa.

SOURCE: Reprinted with permission from MARA/ARMA, Copyright 2001. Taken from Craig, MH, Snow RW, le Sueur D. 1999. A Climate-Based Distribution Model of Malaria Transmission in Sub-Saharan Africa. Parasitology Today 15(3):105-111.

ally symptomatic, not uncommonly with very high parasitemias (parasite numbers in the blood) and a risk of death. Apart from the sheer numbers—not approaching African levels, but substantial—Southeast Asia has been the epicenter of drug-resistant malaria precisely because of this pattern of infection and treatment of nonimmune individuals with heavy parasite loads. Some of the most difficult problems arise in border areas, where refugees have gathered after political conflicts. Isolated tribal groups in various countries, with little or no access to health care, also suffer disproportionately from malaria.

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