Ellen M. Leffler , Gavin Band , George B. J. Busby , Katja Kivinen , Quang Si Le , Geraldine M. Clarke , Kalifa A. Bojang , David J. Conway , Muminatou Jallow , Fatoumatta Sisay-Joof , Edith C. Bougouma , Valentina D. Mangano , David Modiano , Sodiomon B. Sirima , Eric Achidi , Tobias O. Apinjoh , Kevin Marsh , Carolyne M. Ndila , Norbert Peshu , Thomas N. Williams , Chris Drakeley , Alphaxard Manjurano , Hugh Reyburn , Eleanor Riley , David Kachala , Malcolm Molyneux , Vysaul Nyirongo , Terrie Taylor , Nicole Thornton , Louise Tilley , Shane Grimsley , Eleanor Drury , Jim Stalker , Victoria Cornelius , Christina Hubbart , Anna E. Jeffreys , Kate Rowlands , Kirk A. Rockett , Chris C. A. Spencer , Dominic P. Kwiatkowski 1
The malaria parasite Plasmodium falciparum invades human red blood cells via interactions between host and parasite surface proteins. By analyzing genome sequence data from human populations, including 1269 individuals from sub-Saharan Africa, we identify a diverse array of large copy number variants affecting the host invasion receptor genes GYPA and GYPB. We find that a nearby association with severe malaria is explained by a complex structural rearrangement involving the loss of GYPB and gain of two GYPB-A hybrid genes, which encode a serologically distinct blood group antigen known as Dantu. This variant reduces the risk of severe malaria by 40% and has recently risen in frequency in parts of Kenya, yet it appears to be absent from west Africa. These findings link structural variation of red blood cell invasion receptors with natural resistance to severe malaria.