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1 March 2005

Volume 191, Number 5
The Journal of Infectious Diseases 2005;191:799–804
© 2005 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2005/19105-0023$15.00
DOI: 10.1086/427238
MAJOR ARTICLE

Familial Aggregation of Cerebral Malaria and Severe Malarial Anemia

Stéphane Ranque,1,a

Innocent Safeukui,1,a

Belco Poudiougou,2

Abdoulaye Traoré,2

Modibo Keita,2

Diamori Traoré,2

Mahamadou Diakité,2

Mahamadou B. Cissé,3

Marouf M. Keita,3

Ogobara K. Doumbo,2 and

Alain J. Dessein1

1Immunology and Genetics of Parasitic Diseases, Institut National de la Santé et de la Recherche Médicale U.399, Faculty of Medicine, Université de la Méditerranée, Marseilles, France; 2Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto‐Stomatology, University of Mali, and 3Paediatric Ward, Gabriel Touré Hospital, Bamako, Mali

Background.The predominant manifestations of severe malaria in African children are cerebral malaria (CM) and severe malarial anemia (SMA). As a first step toward a family‐based approach to identify the environmental and genetic pathways that contribute to severe malaria, we tested whether it aggregates within families.

Methods.Family history of severe malaria was explored during face‐to‐face interviews with parents. Logistic regression was used to determine whether CM and SMA aggregate within individuals and within families. The pattern of familial aggregation was then expressed as familial odds ratios that were adjusted for relevant risk factors.

Results.This study was of 2811 inhabitants of Bamako, Mali, clustered in 407 nuclear families. The probands were 136 children with severe malaria and 271 healthy children from the community. Within‐person association of CM and SMA was significant (odds ratio, 6.15 [95% confidence interval (CI), 2.62–14.41]). Over a lifetime, with each additional affected relative, the odds of a person contracting CM increased by 1.98 times (95% CI, 1.59–2.45), and the odds of having SMA increased by 1.91 times (95% CI, 1.05–3.47). Over a lifetime, for a child whose sibling had a history of CM, the odds of having CM were 2.49 times greater (95% CI, 1.51–4.10) than the odds for a child whose sibling had no such history; for a child whose sibling had a history of SMA, the odds of having SMA were 4.92 times greater (95% CI, 1.21–19.9) than the odds for a child whose sibling had no such history.

Conclusion.Our data suggest strong familial aggregation of CM and SMA.

Received 18 March 2004; accepted 23 August 2004; electronically published 27 January 2005.

Reprints or correspondence: Dr. Stéphane Ranque, INSERM U.399, Laboratoire de Parasitologie‐Mycologie, Faculté de Médecine, 27 Blvd. Jean Moulin, F‐13385 Marseille Cedex 5, France ().

Cited by

F. VERRA, V.D. MANGANO, D. MODIANO. (2009) Genetics of susceptibility to Plasmodium falciparum : from classical malaria resistance genes towards genome-wide association studies. Parasite Immunology 31:5, 234-253
Online publication date: 1-Jun-2009.
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D KWIATKOWSKI. (2005) How Malaria Has Affected the Human Genome and What Human Genetics Can Teach Us about Malaria. The American Journal of Human Genetics 77:2, 171-192
Online publication date: 1-Sep-2005.
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Margaret J. Mackinnon, Tabitha W. Mwangi, Robert W. Snow, Kevin Marsh, Thomas N. Williams. (2005) Heritability of Malaria in Africa. PLoS Medicine 2:12, e340
Online publication date: 1-Feb-2005.
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  • Financial support: French Research Ministry (VIHPAL 2000 Program); National Institutes of Health/Mali–Malaria Research and Training Center (grant TMRC N0 AI 95‐002‐P50); Association des Universités Partiellement ou Entièrement de Langue Française–Université des Réseaux d'Expression Française (fellowship to I.S.).

  • The first 2 authors contributed equally to this work.

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