Historical texts and archaeological evidence for malaria and its interactions with humans from East to South Asia

It is clear that malaria, a disease caused by Plasmodium spp., has burdened humans throughout our evolutionary paths and remains one of the deadliest maladies to date. Yet, in sharp contrast to the consequence, the human–malaria interaction is a topic that archaeologists do not understand well. This is partially due to the technical difficulties in extracting evidence from archaeological contexts, and partially due to a dearth of interdisciplinary review on this parasite – valuable information is thus veiled by technical as well as linguistic barriers. This review synthesizes archaeological, biological and ecological evidence to explore such interaction on the east side of the Eurasian continent – namely, East, Southeast and South Asia. Materials under scrutiny involve published genetic analysis on pertinent malaria species, ancient Chinese historical/medical documents and osteoarchaeological data on relevant skeletal markers. We examine how the evolution of both Plasmodium and humans engaged in this theatre, and highlight the role played by malaria in driving human demographic shifts as well as the biological and even societal resilience of people to its exposure. Interestingly, humans, in creating favourable environments for us – for instance, watering fields for rice cultivation – had inadvertently yet systematically made it suitable for malaria transmission as well.