Prevalence of Human Genetic Polymorphisms Associated with Protection from Malaria in Regions of Uganda with Different Levels of Malaria Endemicity Moses Kiggundu1, Andrew Walakira1, Federica Verra3, Patrick Kakeeto1, Stephen Tukwasibwe1, Emmanuel Ruhamyankaka1, Chris Drakeley3, Grant Dorsey2, Moses Kamya1, Samuel L. Nsobya1, Philip J. Rosenthal2 1Infectious Diseases Research Collaboration, Kampala, Uganda, 2 University of California, San Francisco, USA, 3 London School of Hygiene and Tropical Medicine Introduction Table showing summary of results Results Mutations in several human genes have been associated with protection against malaria, including the sickle hemoglobin mutation (E6V in the globin gene), the α-thalassemia 3.7kb deletion, a common African variant of the gene encoding glucose-6-phosphate dehydrogenase (G6PD A-), and the CD36 T188G mutation. We hypothesized that the prevalence of genetic polymorphisms that are protective against malaria would be lower in regions of Uganda with lower compared to higher malaria endemicity. Site No. of samples with results Wild type (%) Heterozygous + Homozygous (%) Chi sq test p-value   HbS Jinja 429 320 (75) 109 (25) Kanungu 458 427 (93) 31 (7) < 0.0001 Tororo 434 313 (72) 121 (28) Alpha Thal 430 236 (55) 194 (45) 440 362 (82) 78 (18) 414 196 (47) 218 (53) G6PD 432 355 (82) 77 (18) 453 418 (92) 35 (8) 438 310 (71) 128 (29) CD36 T188G 433 360 (83) 73 (17) 459 377 (82) 82 (18) 442 324 (73) 118 (27) The prevalences of the sickle hemoglobin mutation (28% Tororo, 25% Jinja, 7% Kanungu), the α-thalassemia 3.7 kb deletion (53% Tororo, 45% Jinja, 18% Kanungu) and G6PD A- (29% Tororo, 18% Jinja, 8% Kanungu) were significantly greater in Tororo and Jinja compared to Kanungu (chi square p<0.0001 for all 3 alleles). For the CD36 T188G mutation (27% Tororo, 17% Jinja, 18% Kanungu), the prevalence was significantly greater in Tororo compared to Kanugu and Jinja( p<0.0001). Methods 1,344 subjects were enrolled in cohorts from Kanungu, Jinja, and Tororo Districts, with historically low, moderate, and high malaria endemicity, respectively. DNA was extracted from buffy coat samples using a Qiagen kit. Genes of interest were amplified with PCR (nested where applicable). Amplicons were subjected to mutation-specific restriction. endonuclease digestion (for sickle cell, G6PD A-, and CD36 T188G). Reaction products were resolved by agarose gel electrophoresis. Map of Uganda showing location of study sites Summary and Conclusions Tororo Jinja The prevalence of malaria protective polymorphisms varied across Uganda and was greatest in areas with historically high levels of malaria transmission. Our data are consistent with the hypothesis that the evolutionary pressure of lethal malaria selected for these polymorphisms. . Kanungu Table showing difference in prevalence of polymorphisms between Kanungu compared with Jinja and Tororo. Chi square test was used to test the differences.