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 IELTS
 JOURNAL 
 
176 
Table 1: Annual distribution of malaria infection, approximate, selected regions 

Sub-
Saharan 
Africa 
Southeast 
Asia 
Indian 
subcontinent 
South 
America 
Northeast 
Asia 
New cases
(average per 
year) 
of which 
children 
(average per 
year) 
Deaths
(average per 
year) 
135 million 
48 million 
2.1 million 
66 million 
23 million 
360 000 
46 million 
19 million 
320 000 
17 million 
5.1 million 
110 000 
6 million 
1.7 million 
57 000 
Incidences of cerebral malaria, which is caused by Plasmodium falciparum, the more 
dangerous of the two main malaria parasites, have been responsible for the growing 
number of fatalities in East Africa since the late 1980s. When treatment using 
chloroquine, which in many cases is not even effective, is not available, victims of 
cerebral malaria may survive as little as 24 hours. 
In the 1950s, sub-tropical regions in the United States, southern Europe and elsewhere 
were sprayed with DDT, which eliminated the malaria parasite where used 
appropriately but resulted in resistant mosquitoes where sprayed too often. In other 
parts of the world at this time, chloroquine was introduced as a means of preventing 
infection, and it was thought to be effective in bringing down the number of malaria 
cases until the 1970s, when chloroquine-resistant strains of the parasite began to 
appear. The resistance kept getting stronger as time went on, and in some areas, such 
as Malawi and Kenya, malaria is now no longer preventable with commonly used 
drugs. 
Increasing urbanisation is also responsible for the renewed spread of malaria in Africa. 
Because the parasite is more commonly found in rural areas where mosquitoes can 
breed in large numbers, people who are raised there have a significantly higher 
immunity to it than those reared in the towns and cities. Indeed, 5% of children in the 
countryside die of malaria, and the many who survive it go on to become adults with a 
high degree of natural resistance. This is not the case with people living in urban areas; 
when such people go to visit relatives in the countryside, they are at a much higher risk 
of contracting malaria. 

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