Low prevalence of an acute phase response in asymptomatic children from a malaria-endemic area of Papua New Guinea

Levels of C-reactive protein (CRP), a classic marker for the acute phase response (APR), were measured in children with asymptomatic malaria infection in the Amele region of Papua New Guinea (PNG). Despite the presence of parasitemia, the prevalence of CRP levels consistent with an APR (CRP > 10 μg/mL) was very low (< 10%). Splenomegaly was significantly associated with increased parasitemia (P < 0.001) and CRP levels (P < 0.001), highlighting the importance of splenomegaly as an indicator of recent high density infection in this population. Multivariate analysis showed that CRP levels were significantly associated with splenomegaly, fever, hemoglobin, and age (P ≤ 0.002). CRP levels also increased with increasing parasitemia (P < 0.001) but remained < 3.5 μg/mL. The low levels of CRP indicate that children in the Amele modulate inflammation associated with malaria.