The seroepidemiology of malaria in Middle America. II. Studies on the Pacific coast of Costa Rica.

Serologic studies for malaria using the indirect fluorescent antibody technique suggest that active transmission is either absent or very low in 6 villages on the Pacific side of Costa Rica. Positive titers (1:20 or higher) were seen in the under-15-year age group in three of the study localities, but only 5 such responses were encountered among 249 people examined in this age range. In the adults (15 years and over) from the same 3 villages there were 68 positive titers among 161 examined. There were 43 positive responses in 189 adults from the remaining 3 villages where none of 307 persons under 15 years of age showed a titer of 1:20 or higher to any of the 3 malaria antigens tested (Plasmodium falciparum, P. vivax and P. malariae). These data suggest that the positive responses in the latter villages are more likely to be associated with old or imported cases than with current local transmission. Serologic responses of 1:80 or higher to the P. falciparum antigen suggested the continued presence of this parasite in the population in spite of the paucity of positive blood smears with this species in recent years. Positive titers with the P. malariae antigen suggest that this parasite is probably still present in the area. Such serologic studies help to indicate areas where malaria transmission is active and provide information on parasite reservoirs in particular populations.