The seroepidemiology of malaria in Middle America. V. Antibody responses in an indicator population from an endemic area with attack phase antimalaria activities.

Serologic assessment was carried out in a sample of the population living in an area endemic for malaria in which control measures were being applied. The study area was in El Salvador, Central America, and antimalarial activities consisted of the residual application of the pesticide, propoxur, and drug distribution through a combination of active and passive case detection. Indirect fluorescent antibody (IFA) responses to Plasmodium vivax and P. falciparum antigens were determined on four occasions, at approximately 6-month intervals. The study population consisted of one resident from each of 268 widely distributed houses. Each person was treated with a curative course of chloroquine and primaquine at the beginning of the investigation. An increase in the proportion of positive IFA responses (greater than or equal to 1:20) and an increasing number of serologic conversions (i.e., from negative to positive or a 2-fold increase in titer) during the course of the 18-month study confirmed continued transmission of malaria. The presence of parasites in some individuals without associated serologic changes is discussed.