The serological response to primary malaria infection in urban Ghanaian infants.

Thirty-one (31) newborn infants living in Accra, Ghana, were visited monthly for the first 15 months of life to determine their serologic response to primary malaria infection. Only 10 episodes of seroconversion were observed, the earliest occurring at the 5th month and at a time when maternal-acquired antibodies were absent. Following seroconversion, antibody titers peaked at the 1st month but were generally of low titer (mean geometric titers < 1:80) and declined to undetectable levels within a few months. The majority of the seroconverting infants had no symptoms of illness although in three of the 10 episodes splenic enlargement was noted. This study suggests that symptoms of malaria infection in infancy are often minimal, but that the moderation of symptoms is due to factors other than maternally transmitted antimalarial antibodies. Additionally, malaria appears to be much less common than expected in this urban area of West Africa.