ABSTRACT

A. Historical Aspects and Epidemiology The first case of TTM was reported in 1911 by Wolsey (1), and more than 3000 cases have been described so far (2), although these numbers may represent less than 50% of the actual cases (3). Although malaria has been eradicated in almost all European countries, the United States, Australia, and Japan, it is still present in 102 countries (4-6), where more than 120 million people are infected annually,

with 1 million deaths and nearly 300 million carrying the parasite. Countries in tropical Africa are responsible for 80% of all clinical cases and more than 90% of all parasite carriers in the world. Excluding the African continent, 90% of cases reported to WHO are from 19 different countries, with some 75% of them concentrated in 9 countries: India, Brazil, Afghanistan, Sri Lanka, Thailand, Indonesia, Vietnam, Cambodia, and China (decreasing order of frequency). Malaria is concentrated in certain regions within a single country. For example, though 85% of the Brazilian geographic territory is exposed to malaria, less than 15% of the Brazilian population lives in the affected area, with nearly 99% of all cases detected in the Amazon region. In addition, nearly 40% of the world population, or 1.8 billion people (1992), still remain exposed to varying degrees of risk of malarial infection (4,5).