The aim of this study was to determine the prevalence of malaria infection and antibodies against the repetitive epitopes of the circumsporozoite (CS) proteins of Plasmodium falciparum, P. malariae, P. vivax VK210, P. vivax VK247, and P. vivax-like in individuals living in the states of Rondônia, Pará, Mato Grosso, Amazonas, and Acre. Active malaria transmission was occurring in all studied sites, except in Acre. P. falciparum was the predominant species in Pará and Rondônia and P. vivax in Mato Grosso. Infection by P. malariae was low but this Plasmodium species was detected in Rondônia (3.5%), Mato Grosso (2.5%), and Pará (0.8%). High prevalence and levels of serological reactivity against the CS repeat peptides of P. falciparum were detected in Rondônia (93%) and Pará (85%). Sera containing antibodies against the CS repeat of P. malariae occurred more frequently in Rondônia (79%), Pará (76%), and Amazonas (68%). Antibodies against the repeat epitope of the standard CS protein of P. vivax VK210, P. vivax VK247, and P. vivax-like were more frequent in Rondônia, Pará, and Mato Grosso. The high frequency of reactions to P. malariae in most of the areas suggests that the infection by this Plasmodium species has been underestimated in Brazil.
Key words: Plasmodium -infection -Amazon region -BrazilMalaria remains as a serious health problem in the Amazon Basin of Brazil and approximately 99% of some 600,000 cases notified annually occur in this region (Ministério da Saúde 2003, Coura et al. 2006. Malaria is heterogeneously distributed in the nine states of the Legal Amazon and the number of annual cases fluctuates, increasing in some states where gold mining activities take place, massive migration occurs, and new settlements projects are implemented. However, the states of Pará, Amazonas, and Rondônia are always among the major malaria-endemic regions. Based on microscopic examination from the records of the Brazilian Ministry of Health, P. falciparum and P. vivax are the most prevalent Plasmodium. The reported prevalence of P. malariae is very low (< 1%). In the last 15 years the number of P. vivax has increased and presently accounts for 78% of all malaria cases reported in the country. Besides the classic P. vivax VK210, two species-specific circumsporozoite (CS) protein variants P. vivax VK247 (Rosenberg et al. 1989) and P. vivax-like (Qari et al. 1993, 1994 were described. The human P. vivax-like parasite has a CS repeat which corresponds to the simian parasite P. simiovale. Otherwise the identity of these parasites is not clear, since a line of the human isolates has not yet been obtained and the clinical manifestation of these infections is unknown.Antibodies to sporozoites represent a serological transmission indicator and have been used in epidemiological studies to estimate the level of malaria in endemic areas. It is well known that individuals living in malaria endemic areas exposed to sporozoite infections develop antibodies directly to the repetitive epitopes of the CS protein. The prevalence and le...