Taken together, our findings and previous reports on TLR4 Asp299Gly and Thr399Ile polymorphisms in malaria endemic countries strongly point to the relevance of other infectious diseases that also provide selection pressure on TLR4. They include tuberculosis, HIV, gram negative bacterial infection, candidiasis, meningitis and respiratory syncytial viral infection [5, 11]. This evidence concerns the gene TLR4 and gram-negative bacterial infections.