Studies on the pathogenesis of severe malarial anemia suggest that anemia mainly results from the suppression of erythropoietin-induced erythropoiesis by parasite factors, such as hemozoin,38 mediated by inflammatory cytokines.10 In Malawian children, it was found that irrespective of the etiological factor, suppression of erythropoiesis leading to red cell production failure was the predominant pathway for the development of SA.11 Interestingly, we found no significant difference in reticulocyte count across groups. This evidence concerns the gene EPO and anemia (phenotype).