TNF and Plasmodium vivax malaria: Many explanations have also been proposed for severe manifestations in vivax malaria like adherence of platelets stimulated by tumor necrosis factor (TNF) to endothelium [4]; bridges formed by platelets between RBCs and endothelial cells as in falciparum malaria [5] and stimulation of platelets by parasitised RBCs triggering apoptosis in endothelial cells pretreated with TNF in a pathway mediated by tumor growth factor- (TGF-) β1 [6].