| Summary: | <p>Abstract</p> <p>Background</p> <p>In high-transmission areas, developing immunity to symptomatic <it>Plasmodium falciparum </it>infections requires 2–10 years of uninterrupted exposure. Delayed malaria-immunity has been attributed to difficult-to-develop and then short-lived antibody responses.</p> <p>Methods</p> <p>In a study area with <0.5 <it>P. falciparum </it>infections/person/year, antibody responses to the MSP1-19kD antigen were evaluated and associations with <it>P. falciparum </it>infections in children and adults. In months surrounding and during the malaria seasons of 2003–2004, 1,772 participants received ≥6 active visits in one study-year. Community-wide surveys were conducted at the beginning and end of each malaria season, and weekly active visits were completed for randomly-selected individuals each month. There were 79 <it>P. falciparum </it>infections with serum samples collected during and approximately one month before and after infection. Anti-MSP1-19kD IgG levels were measured by ELISA.</p> <p>Results</p> <p>The infection prevalence during February-July was similar in children (0.02–0.12 infections/person/month) and adults (0.03–0.14 infections/person/month) and was negligible in the four-month dry season. In children and adults, the seroprevalence was maintained in the beginning (children = 28.9%, adults = 61.8%) versus ending malaria-season community survey (children = 26.7%, adults = 64.6%). Despite the four-month non-transmission season, the IgG levels in <it>Plasmodium</it>-negative adults were similar to <it>P. falciparum</it>-positive adults. Although children frequently responded upon infection, the transition from a negative/low level before infection to a high level during/after infection was slower in children. Adults and children IgG-positive before infection had reduced symptoms and parasite density.</p> <p>Conclusion</p> <p>Individuals in low transmission areas can rapidly develop and maintain αMSP1-19kD IgG responses for >4 months, unlike responses reported in high transmission study areas. A greater immune capacity might contribute to the frequent asymptomatic <it>P. falciparum </it>infections in this Peruvian population.</p>
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