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Understanding naturally acquired immunity to infections caused by  Plasmodia  in different malaria endemicity settings is needed for better vaccine designs and for exploring antibody responses as a proxy marker of malaria transmission intensity. This study investigated the sero-epidemiology of malaria along the international border between China and Myanmar, where malaria elimination action plans are in place. This study recruited 233  P .  vivax  and 156  P .  falciparum  infected subjects with acute malaria at the malaria clinics and hospitals. In addition, 93 and 67 healthy individuals from the same endemic region or from non-endemic region, respectively, were used as controls. Acute malaria infections were identified by microscopy. Anti-recombinant PfMSP1 19  and PvMSP1 19  antibody levels were measured by ELISA. Antibody responses to respective MSP1 19  were detected in 50.9% and 78.2% patients with acute  P .  vivax  and  P .  falciparum  infections, respectively. There were cross-reacting antibodies in  Plasmodium  patients against these two recombinant proteins, though we could not exclude the possibility of submicroscopic mixed-species infections. IgG1, IgG3 and IgG4 were the major subclasses. Interestingly, 43.2% of the healthy endemic population also had antibodies against PfMSP1 19 , whereas only 3.9% of this population had antibodies against PvMSP1 19 . Higher antibody levels were correlated with age and parasite density, but not with season, gender or malaria history. Both total IgG and individual IgG subclasses underwent substantial declines during the convalescent period in three months. This study demonstrated that individuals in a hypoendemic area with coexistence of  P .  vivax  and  P .  falciparum  can mount rapid antibody responses against both PfMSP1 19  and PvMSP1 19 . The significantly higher proportion of responders to PfMSP1 19  in the healthy endemic population indicates higher prevalence of  P .  falciparum  in the recent past. Specific antibodies against PvMSP1 19  could serve as a marker of recent exposure to  P .  vivax  in epidemiological studies.

plos one

Naturally Acquired Antibody Responses to Plasmodium vivax and Plasmodium falciparum Merozoite Surface Protein 1 (MSP1) C-Terminal 19 kDa Domains in an Area of Unstable Malaria Transmission in Southeast Asia