Stunned health officials are struggling to cope with a worldwide outbreak of malaria, the deadly mosquito-borne malady that doctors once talked about eradicating.

It still reigns as the No. 1 killer of children and most widespread communicable disease in the tropical lowlands of Central America, South America and Southeast Asia and the equatorial region of Africa, according to the World Health Organization.

"It's a major tragedy and a public health problem," said Dr. Kent Campbell, malaria branch chief at the national Centers for Disease Control in Atlanta. "The word 'shock' fairly describes the reaction of the world medical community to malaria's continued presence on the scene."

Statistics compiled by the WHO show malaria epidemics in many hot weather countries now far surpassing some of the record levels reached in the 1960s.

In India, where 60,000 cases were reported in 1962, the high point of the '60s outbreaks, officials this year have received reports of 4 million cases.

In the United States between 1978 and 1980, the number of recorded cases doubled, but officials attributed the increase to cases contracted abroad or acquired by transfusion from a malaria-infected donor or to immigrants.

The CDC reported 1,864 cases in the United States in 1980, the largest annual number in the past 20 years. Attributed mainly to a surge in the number of Vietnam and Cambodian refugees, the case number is declining this year, the CDC reported this month.