Some studies have suggested associations between high levels of cytokines and severe malaria [38], [39], but these have been challenged recently by work showing that high levels of pro-inflammatory cytokines such as tumor necrosis factor (TNF) are poor indicators of HCM in African children and that markers of localised endothelial cell inflammation (e.g., Angiopoietin 1/Angiopoietin 2 ratio) are more strongly associated [40], [41]. Here, TNF is linked to malaria.