RESEARCH ARTICLE Plasmodium falciparum an

Full list of author information is available at the end of the articleBackground Severe life threatening P. falciparum malaria is a major cause of mortality and morbidity in young children in sub-Saharan Africa. In endemic areas, severe malaria is most prevalent in children under the age of five years, before they acquire immunity to severe disease as a re-sult of repeated exposure. Severe malaria manifests in children in three partly overlapping syndromes; impaired consciousness (IC), respiratory distress (RD), and severe malarial anemia (SMA) [1]. Of these, IC and RD were found to be the key indicators of life threatening malaria in a hospital setting in sub-Saharan Africa [1]. The pathophysiological process underlying each of these syndromes is still not understood. Disturbed microcircula-tion is thought to play a major role [2]. In cerebral malaria (CM) (severely impaired consciousness), sequestration of parasite infected erythrocytes (IE) in the microvasculature of the brain is thought to be important [3-6]. PfEMP1, a parasite encoded protein expressed on the surface of the IE, interacts with host receptors on the microvascular endothelia as well as unparasitized eryth