Of note, the 17th most significantly enriched KEGG pathway was “Malaria” (FDR p = 4.6E-13) and included differential expression of the following genes in that pathway: CXCL8, IL6, CCL2, IL1A, IL1B, TNF, IFNG, VCAM1, ICAM1, CD40, and LRP1. Taken together these data on monocyte subset proportions, TLR responses, and gene expression profiles suggest a hyper-inflammatory state in Kenyan adult monocytes that is distinct from both Kenyan child monocytes as well as US adult monocytes, likely secondary to complex gene-environment interactions and their influence on the aging epigenome. This evidence concerns the gene ICAM1 and malaria.