Journal Article

The Role of Red Blood Cell Polymorphisms in Resistance and Susceptibility to Malaria

Bertrand Lell, Jürgen May, Ruprecht J. Schmidt-Ott, Leopold G. Lehman, Doris Luckner, Bernhard Greve, Peter Matousek, Daniela Schmid, Klaus Herbich, Frank P. Mockenhaupt, Christian G. Meyer, Ulrich Bienzle and Peter G. Kremsner

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 4, pages 794-799
Published in print April 1999 | ISSN: 1058-4838
Published online April 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515193
The Role of Red Blood Cell Polymorphisms in Resistance and Susceptibility to Malaria

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In regions highly endemic for Plasmodium falciparum malaria, red cell polymorphisms that confer resistance to severe disease are widespread. Sickle cell trait, a-thalassemia, glucose-6-phosphate dehydrogenase deficiency, and blood groups were determined in 100 children from Gabon with severe malaria who were matched with 100 children with mild malaria and followed up for evaluation of reinfections. The sickle cell trait was significantly associated with mild malaria and blood group A with severe malaria. During follow-up, the original severe cases had significantly higher rates of reinfection than the original mild cases, with higher parasitemia and lower hematocrit values. Incidence rates did not differ in the context of erythrocyte polymorphisms, but patients with sickle cell trait presented with markedly lower levels of parasitemia than those without. Thus, the severity of malaria is partly determined by the presence of blood group A and the sickle cell trait. The different presentation of reinfections in severe versus mild cases probably reflects different susceptibility to malaria.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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