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. 2016 Nov 9;14:123–130. doi: 10.1016/j.ebiom.2016.11.011

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Crown Copyright © 2016 Published by Elsevier B.V.

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Fig. 2 — Parasite growth and invasion in RBCs from anemic children (Hgb < 11 g/dl) at baseline.

A) P. falciparum (strain FCR3-FMG) growth rates are proportional to hemoglobin concentration. Growth assays were performed in RBCs drawn from anemic children at baseline (Day 0) and values are presented relative to growth in RBCs from non-anemic donors. Each dot represents the mean result of triplicate growth assays from each donor and the error bars represent 95% CI. One-way ANOVA indicates the means are significantly different between Days (p < 0.05); specifically, post-hoc analysis with Tukey's test indicates significant differences between Hgb levels 7–9 g/dl and 10.1–11 g/dl (*p < 0.05).

B) P. falciparum clinical isolates from The Gambia exhibit decreased growth in RBCs from anemic children at Day 0. Growth of 3 different clinical strains (952, 998, 1029) was compared to growth of a laboratory strain (FCR3-FMG) in RBCs from five anemic children. Each dot represents the mean result of triplicate growth assays from each donor relative to growth in non-anemic RBCs and error bars represent the 95% CI. The mean relative growth rate in anemic RBCs for each strain is decreased compared to 100% growth in non-anemic RBCs.

C) Direct comparison of invasion into RBCs from anemic and non-anemic donors using P. falciparum laboratory strains. Invasion experiments for RBCs from all anemic donors (drawn at Day 0) were performed independently and each experiment was performed in triplicate. Data show the mean SI using RBCs from 10 anemic donors for strain 3D7 and 15 for FCR3-FMG. The SI defines the relative susceptibility to invasion of two different types of RBCs. The marker represents the SI point estimate and the bar represents the 95% CI. An SI of 1.0 indicates no difference in parasite invasion of two RBC populations. Both strains 3D7 and FCR3-FMG give SI values significantly decreased from the control value of 1.0.

D) Direct comparison of invasion into RBCs from either anemic or non-anemic donors using clinical strains of P. falciparum. Invasion experiments for RBCs from all anemic donors (drawn at Day 0) were performed independently and each experiment was performed in triplicate. Data show the mean SI using RBCs from 5 anemic donors for all strains (FCR3-FMG, 952, 998, 1029). The marker represents the SI point estimate and the bar represents the 95% CI. An SI of 1.0 indicates no difference in parasite invasion of two RBC populations.