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Prevention of cerebral malaria in children in Papua New Guinea by southeast Asian ovalocytosis band 3.
S J Allen
S J Allen
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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A O'Donnell
A O'Donnell
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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N D Alexander
N D Alexander
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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C S Mgone
C S Mgone
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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T E Peto
T E Peto
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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J B Clegg
J B Clegg
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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M P Alpers
M P Alpers
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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D J Weatherall
D J Weatherall
Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, United Kingdom.
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Southeast Asian ovalocytosis (SAO) occurs at high frequency in malarious regions of the western Pacific and may afford a survival advantage against malaria. It is caused by a deletion of the erythrocyte membrane band 3 gene and the band 3 protein mediates the cytoadherence of parasitized erythrocytes in vitro. The SAO band 3 variant may prevent cerebral malaria but it exacerbates malaria anemia and may also increase acidosis, a major determinant of mortality in malaria. We undertook a case-control study of children admitted to hospital in a malarious region of Papua New Guinea. The SAO band 3, detected by the polymerase chain reaction, was present in 0 of 68 children with cerebral malaria compared with six (8.8%) of 68 matched community controls (odds ratio = 0, 95% confidence interval = 0-0.85). Median hemoglobin levels were 1.2 g/dl lower in malaria cases with SAO than in controls (P = 0.035) but acidosis was not affected. The remarkable protection that SAO band 3 affords against cerebral malaria may offer a valuable approach to a better understanding of the mechanisms of adherence of parasitized erythrocytes to vascular endothelium, and thus of the pathogenesis of cerebral malaria.
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| Past two years | Past Year | Past 30 Days | |
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