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This study focuses on two very low transmission areas in Loreto (Peruvian Amazon) and aims to determine the relationship between malaria exposure and proximity to health facilities. Individual data was collected from 38 villages in Indiana and Belen, including geo-referenced households and blood samples for microscopy, PCR and serological analysis. A segmented linear regression model identified significant changes in seropositivity trends among different age groups. Local Getis-Ord Gi* statistic revealed clusters of households with high (hotspots) or low (coldspots) seropositivity rates. Findings from 4000 individuals showed a seropositivity level of 2.5% (95%CI: 2.0%-3.0%) for <jats:italic>P. falciparum<\/jats:italic> and 7.8% (95%CI: 7.0%-8.7%) for <jats:italic>P. vivax<\/jats:italic>, indicating recent or historical exposure. The segmented regression showed exposure reductions in the 40\u201350 age group (\u03b21\u2009=\u20090.043, p\u2009=\u20090.003) for <jats:italic>P. vivax<\/jats:italic> and the 50\u201360 age group (\u03b21\u2009=\u20090.005, p\u2009=\u20090.010) for <jats:italic>P. falciparum<\/jats:italic>. Long and extreme distance villages from Regional Hospital of Loreto exhibited higher malaria exposure compared to proximate and medium distance villages (p\u2009&lt;\u20090.001). 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