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High frequency of the erythroid silent Duffy antigen genotype and lack of Plasmodium vivax infections in Haiti

Thomas A Weppelmann12, Tamar E Carter345, Zhongsheng Chen3, Michael E von Fricken1, Yves S Victor6, Alexander Existe7 and Bernard A Okech12*

Author Affiliations

1 Department of Environmental and Global Health, University of Florida, PO Box 100188, Gainesville, FL 32610, USA

2 Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd, P.O. Box 100009, Gainesville, FL 32610, USA

3 Genetics Institute, University of Florida, 2033 Mowry Rd, PO Box 103610, Gainesville, FL 32610, USA

4 Department of Anthropology, University of Florida, 1112 Turlington Hall, PO Box 117305, Gainesville, FL 32611, USA

5 Department of Epidemiology, College of Public Health and Health Professions, University of Florida, PO Box 100231, Gainesville, FL 32611, USA

6 Blanchard Clinic, Family Health Ministries Haiti, Terre Noire, Port au Prince, Haiti

7 National Public Health Laboratory, Ministry of Public Health and Population (MSPP), Delmas 33, Port au Prince, Haiti

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Malaria Journal 2013, 12:30  doi:10.1186/1475-2875-12-30

Published: 24 January 2013



Malaria is a significant public health concern in Haiti where approximately 30,000 cases are reported annually with CDC estimates as high as 200,000. Malaria infections in Haiti are caused almost exclusively by Plasmodium falciparum, while a small number of Plasmodium malariae and an even smaller number of putative Plasmodium vivax infections have been reported. The lack of confirmed P. vivax infections in Haiti could be due to the genetic background of native Haitians. Having descended from West African populations, many Haitians could be Duffy negative due to a single nucleotide polymorphism from thymine to cytosine in the GATA box of the promoter region of the Duffy antigen receptor for chemokines (DARC) gene. This mutation, encoded by the FYES allele, eliminates the expression of the Duffy antigen on erythrocytes, which reduces invasion by P. vivax. This study investigated the frequency of the FYES allele and P. vivax infections in malaria patients with the goal of uncovering factors for the lack of P. vivax infections reported in Haiti.


DNA was extracted from dried blood spots collected from malaria patients at four clinic locations in Haiti. The samples were analysed by polymerase chain reaction (PCR) for the presence of the P. vivax small subunit ribosomal RNA gene. PCR, sequencing, and restriction enzyme digestion were used to detect the presence of the FYES allele. Matched samples were examined for both presence of P. vivax and the FYES allele.


No cases of P. vivax were detected in any of the samples (0/136). Of all samples tested for the FYES allele, 99.4% had the FYES allele (163/164). Of the matched samples, 99% had the FYES allele (98/99).


In this preliminary study, no cases of P. vivax were confirmed by PCR and 99% of the malaria patients tested carried the FYES allele. The high frequency of the FYES allele that silences erythroid expression of the Duffy antigen offers a biologically plausible explanation for the lack of P. vivax infections observed. These results provide insights on the host susceptibility for P. vivax infections that has never before been investigated in Haiti.

Plasmodium vivax; Malaria; Hispaniola; Haiti; Duffy antigen receptor for chemokines (DARC); Duffy negative; Genetic susceptibility