The pathogenesis of severe
malaria is still not clearly understood and there are few substantial data describing the association of specific parasite genotypes with the severity of Plasmodium falciparum
infection in humans. The merozoite
surface proteins 1 and 2 (MSP-1 and MSP-2) of P. falciparum play a crucial role in the parasite's invasion of the human host and the subsequent manifestation of the complications of severe
malaria. Attempts at associating
msp-1 and msp-2 genotypes with the severity of P.
falciparum malaria therefore appear worthwhile. In the present study, based in the
malaria-endemic district of Sundergarh, in the Indian state of Orissa, the
msp-1, msp-2 and pfcrt genotypes of P. falciparum infecting children were investigated and compared against the severity of
malaria in each donor child. The two major complications seen in the subjects,
cerebral malaria and severe anaemia, were each found to be significantly associated with the RO33 subtype of
msp-1 and the 3D7 subtype of msp-2. Although the study isolates showed a high degree of multiclonicity (multiplicity of
infection = 1.9) and of polymorphism in
msp-1 and -2, almost all (95%) of the isolates had the K76T mutation in their pfcrt genes.