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Low Frequency of Anti-Plasmodium Falciparum Circumsporozoite Repeat Antibodies and Rate of High Malaria Transmission in Endemic Areas of Rondonia State in Northwestern Brazil

In areas studied in the Rondonia State of Brazil, a high rate of malaria transmission and a low prevalence of anti-(NANP)₄ antibodies are reported. The entomologic data are comparable to those observed in some malaria-endemic areas of Africa and Asia. However, the frequency of individuals with antibodies to the immunodominant epitope of the circumsporozoite protein of Plasmodium falciparum recorded in the four localities of Rondonia state was very low when compared with the frequencies recorded in other African and Asian endemic areas. Most of the studies performed in Africa and Asia concerned the native population of hyperendemic areas, whereas we studied a migrant population who were mostly from malaria-free areas of Brazil and living in Rondonia State for 2–4 years. In positive individuals the antibody production was influenced by previous malaria experience, suggesting that infective bites must occur in cumulative numbers before anti-(NANP)₄ antibodies are detected. Therefore, it is possible that the individuals described in this report have not been exposed long enough to malaria infection to develop detectable levels of anti-(NANP)₄ antibodies.