Background: Plasmodium falciparum infection leads to alterations in B cell subset distribution. During infancy,
development of peripheral B cell subsets is also occurring. However, it is unknown if infants living a malaria
endemic region have alterations in B cell subsets that is independent of an age effect.
Methods: To evaluate the impact of exposure to P. falciparum on B cell development in infants, flow cytometry
was used to analyse the distribution and phenotypic characteristic of B cell subsets in infant cohorts prospectively
followed at 12, 18 and 24 months from two geographically proximate regions in western Kenya with divergent
malaria exposure i.e. Kisumu (malaria-endemic, n = 24) and Nandi (unstable malaria transmission, n = 21).
Results: There was significantly higher frequency and absolute cell numbers of CD19+ B cells in Kisumu relative to
Nandi at 12(p = 0.0440), 18(p = 0.0210) and 24 months (p = 0.0493). No differences were observed between the
infants from the two sites in frequencies of naïve B cells (IgD+CD27-) or classical memory B cells (IgD-CD27+).
However, immature transitional B cells (CD19+CD10+CD34-) were higher in Kisumu relative to Nandi at all three
ages. In contrast, the levels of non-class switched memory B cells (CD19+IgD+CD27+) were significantly lower
overall in Kisumu relative to Nandi at significantly at 12 (p = 0.0144), 18 (p = 0.0013) and 24 months (p = 0.0129).
Conclusions: These data suggest that infants living in malaria endemic regions have altered B cell subset
distribution. Further studies are needed to understand the functional significance of these changes and long-term
impact on ability of these infants to develop antibody responses to P. falciparum and heterologous infections