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 In addition to human chemokine responses in natural malaria infections, it was important to identify parasite genotypes circulating in Apac District in Northern Uganda in preparation for malaria vaccine clinical trials. Prior knowledge of baseline parasite genotypes could provide useful insights about not only the design of region-specific vaccines but also the emergence of vaccine variants responsible for breakthrough infections in vaccinated subjects. We investigated age-dependent distribution of alleles or haplotypes of genes encoding three Plasmodium falciparum EBA-175, SERA5, and CSP candidate vaccines was investigated in parasite isolates from 250 individuals aged < 5 years to above 10 years by polymerase chain reaction (PCR) or nucleotide sequencing of PCR products.  eba-175 FCR3 allele was more prevalent (44 %) by comparison with the CAMP allele (14.8 %) with FCR3 being predominant among infants while CAMP was predominant in older individuals. The amino-terminal region/octamer repeats (OR) comprise of either 5 octamer units of 175 bp (allele 1) or 6 octomer units of 199 bp (allele 2) designated ORI and II. Both sera5 alleles ORI and ORII were observed but the ORII allele was more prevalent and its carriage was associated with age, parasite density, and clinical outcomes.

There was remarkable csp diversity in the Th2/Th3 region but the majority of CSP haplotypes were unique to the site. More CSP haplotypes (10/16) were harbored by infants compared to older individuals (2/16). In conclusion, eba-175, sera5, and csp genes are under immune selection pressure in Apac District. Additional studies in collaboration with Professor Mats Wahlgren of the Karolinska Institute (Sweden) characterized var gene transcription dynamics, genome wide gene amplifications and deletions, and PfEMP1-DBL1 alpha amino acid motifs in P. falciparum isolates from children with severe malaria. These data will inform the development of malaria vaccines for this region