High levels of Plasmodium falciparum rosetting in all clinical forms of severe malaria in African children.


Journal Article

Plasmodium falciparum rosetting (the spontaneous binding of infected erythrocytes to uninfected erythrocytes) is a well-recognized parasite virulence factor. However, it is currently unclear whether rosetting is associated with all clinical forms of severe malaria, or only with specific syndromes such as cerebral malaria. We investigated the relationship between rosetting and clinical malaria in 209 Malian children enrolled in a case-control study of severe malaria. Rosetting was significantly higher in parasite isolates from severe malaria cases compared with non-severe hyperparasitemia and uncomplicated malaria controls (F(2,117) = 8.15, P < 0.001). Analysis of sub-categories of severe malaria (unrousable coma, severe anemia, non-comatose neurological impairment, repeated seizures or a small heterogeneous group with signs of renal failure or jaundice) showed high levels of rosetting in all sub-categories, and no statistically significant differences in rosetting between sub-categories (F(4,67) = 1.28, P = 0.28). Thus rosetting may contribute to the pathogenesis of all severe malaria syndromes in African children, and interventions to disrupt rosetting could be potential adjunctive therapies for all forms of severe malaria in Africa.

Full Text

Duke Authors

Cited Authors

  • Doumbo, OK; Thera, MA; Koné, AK; Raza, A; Tempest, LJ; Lyke, KE; Plowe, CV; Rowe, JA

Published Date

  • December 2009

Published In

Volume / Issue

  • 81 / 6

Start / End Page

  • 987 - 993

PubMed ID

  • 19996426

Pubmed Central ID

  • 19996426

Electronic International Standard Serial Number (EISSN)

  • 1476-1645

Digital Object Identifier (DOI)

  • 10.4269/ajtmh.2009.09-0406


  • eng

Conference Location

  • United States