Malaria killed 627,000 young children 2021. The major virulence factor of the deadly Plasmodium falciparum (Pf) malaria parasite is the ‘knobs’; raised nanostructures expressed on the outside of the infected red blood cells (IRBCs). These knobs (and associated proteins) cause the infected red cell to become stiff and sticky, causing them to block the microcapillaries of vital organs. However, while this is true for malaria parasites from Africa, we have found that throughout sites in the Asia Pacific (Myanmar and Papua) most of the Pf IRBCs lack knobs.

This study aims to investigate the extent of Pf knobless populations and fully characterise the molecular, nano-structural and biomechanical factors associated with knobless Pf IRBCs. This study investigates a paradigm at the very heart of malaria pathobiology and we hope that our findings provide insights into parasite evolution and malaria in the Asia-Pacific.