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\r\n\r\n\tThe book's goal is to provide a game-changing and cross-disciplinary forum that brings together experts from academia, industry, and government to advance the frontiers of theories, methods, systems, and applications.
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In malaria-endemic areas, a significant proportion of children harbor parasites without presenting signs of clinical malaria and are considered asymptomatic cases [1]. Moreover, in communities where children are repeatedly infected with malaria, one can question why some children die while others do not. Variant-specific immunity may help explain chronic low-grade malaria infection without clinical symptoms [2]. A better knowledge of the polymorphic host genes associated with resistance to clinical malaria and/or with high parasite densities might provide new insights into disease mechanisms, and suggest new approaches for prophylactic or therapeutic interventions [3, 4].
The ABO blood groups consist of A, B, and H carbohydrate antigens which can regulate protein activities during infection and antibodies against these antigens [9, 10, 11]. Several studies did try to establish an association between severe malaria and the ABO-blood group type [11, 12, 13], with some reporting significant associations on infection status and a particular ABO blood group [11, 13].
The relationship between ABO and malaria was first suggested more than 40 years ago [14]. Few studies have corroborated this hypothesis [8, 11, 14, 15], but some studies showed a weak association [2]. In India, for example, a significantly lower frequency of
This study aimed to investigate the association between the ABO blood group and malaria susceptibility among Fulani compared to other sympatric ethnic groups living in Burkina Faso.
We offer four perspectives in support of this investigation:
The prevalence of the ABO blood group, in both children and adults residing in the rural areas of Burkina Faso;
The current distribution of ABO groups and
Clinical outcomes during
For a long time ago, the ABO blood group system has been suggested to be associated with infectious diseases including malaria. ABO blood groups appear to protect against malaria, through loss of function due to a defective allele: the O phenotype of the ABO system seems to confer protection against
Gene (chromosome) | Protein | Mutation | Number of mutations | Variant | Reported Genetic Associations with Malaria | Mechanistic hypotheses proposed protective mechanism | Reference | Distribution | High-low Frequency |
---|---|---|---|---|---|---|---|---|---|
ABO (9q34) O | Glycosyl transferase enzyme | Deletion of nucleotide 261 in exon 6 | major | ABO single nucleotide deletion (rs8176719)-Blood group O | O alleles protect against uncomplicated malaria and severe malaria. | Reduced | Rowe et al. (2007), Rowe et al. (1995), Udomsangpetch et al. (1993), MalariaGEN (2014), Ndila et al. (2018), Tishkoff SA, et al. (2004). Silvia N. Kariuki | South America, Africa, Western Europe | Near 100% in native South Americans to about 0.3% in some Asians |
How the ABO blood group system affect susceptibility and resistance to
The human ABO gene consists of seven exons that are more than 18 kb in length and genomic analysis has found over 70 alleles at this locus, suggesting that it is one of the polymorphic genes in humans [1]. The three main antigenic classes (A, B, and O) are all comprised of numerous alleles in both coding and non-coding sequences [1].
The O alleles share a one-nucleotide deletion in codon 87 of exon 6 resulting in a frameshift mutation and premature termination of the polypeptide [2, 3]. O alleles are the most common of the three allelic classes (about 0.6 worldwide) and have frequencies between 0.3 and 0.7 in most populations. The A alleles generally have frequencies between 0.2 and 0.3, and the B alleles have frequencies between 0.1 and 0.2 [4]. There is substantial evidence supporting the importance of allele O for protecting against malaria, based primarily on the consistency between the worldwide distributions of ABO variants and the historical presence of malaria. Uneke (2007) showed that the O allele, which is more frequent in malaria-endemic regions, is associated with greater resistance to malaria, in contrast to the A and B genotypes, which are less resistant [5]. Fry et al. (2008) [6] corroborated this finding through a study in three African populations showing a strong association of O individuals with resistance to severe malaria and a recessive effect in AO and BO individuals. Consequently, AO and BO would have the same susceptibility or sensitivity to malaria as AA and BB individuals; with AB genotype individuals being the most sensitive. The O allele is thought to protect against severe malaria through a mechanism of reduced reinitiation (
However, although the major O alleles share a one-nucleotide deletion, they differ in the number of nucleotide substitutions in both exons and introns. The O human alleles, although different from the O chimpanzee allele [8], are much older [1]. The most common O alleles, O01 and O02, are the result of separate mutations and are 1.15 and 2.5 million years old, respectively. In other words, assuming that the O allele protects from malaria, this protection may be a result of selection originally favoring O alleles for some other reason.
The study was conducted in four shrub-savanna villages located northeast (Barkoumbilen and Barkoundouba) and east (Bassy and Zanga) of Ouagadougou, the capital city of Burkina Faso (see Figure 1).
Study site in Burkina. The study was carried out in four rural villages of shrubby savannah areas of Burkina Faso: northeast (Nioniokodogo and Barkoundouba), and east (Bassy and Zanga) of the capital town Ouagadougou. Compounds of the various ethnic groups are represented as capital letters. Inset/smaller map represents the study site relative to the whole country.
In the northeast zone, the Mossi and Rimaibè communities inhabit the village of Barkoumbilen, while the Fulani and Rimaibè inhabit the village of Barkoundouba. The Fulani and Rimaibe are present in both villages, so the Rimaibe represent an optimal internal control for the study. The two villages are 5 km apart. In the eastern zone, Mossi and Fulani communities independently inhabit two villages, Zanga and Bassy, about 1(one) km apart.
Malaria transmission in the study areas is hyperendemic and seasonal, with a rainy season from June to October. The entomological inoculation rate (EIR) is estimated to be around 200–300 infecting bites per person per year and is comparable between villages [6]. The main malaria vectors are
The population of the study area is predominantly of the Mossi ethnic group, followed by the widespread Fulani, who are generally closely associated with the Rimaibe (a hybrid of the two in terms of customs and even genetics). All three populations live in similar houses. However, the Fulani group, while adopting the habits of the sedentary Mossi populations, has retained their pastoral activities so that their habitat is characterized by the presence of cattle herds.
The total population of the four villages was obtained from a general census and enrolled in a demographic monitoring process. Except for children under 6 months of age, the entire population was eligible for the study and was characterized/designated into two groups: participants aged 0.6 to 17 years and participants aged 18 years and older.
The study was conducted for two consecutive years and consisted of five cross-sectional surveys (
Four surveys during the high malaria transmission seasons: in the middle of August 2007 and 2008; and in the middle of November/December 2007 and 2008.
One survey in the middle of the low transmission/dry season: March 2008.
Total subject (n) | Grouped by ethnicity | ||||
---|---|---|---|---|---|
Mossi n (%) | Fulani n (%) | Rimaibe n (%) | |||
559 | 163 | 209 | 176 | ||
380 (68.1) | 120 (73.2) | 147 (69.0) | 113 (62.4) | ||
178 (31.9) | 44 (26.8) | 66 (31.0) | 68 (37.6) | ||
224 (40.9) | 72 (44.2) | 90 (43.1) | 62 (35.2) | ||
324 (59.1) | 91 (55.8) | 119 (56.9) | 114 (64.8) | ||
40.5 (222) | 29.4 (48) | 52.6 (110) | 36.4 (64) | ||
26.6 (146) | 40.5 (66) | 13.4 (28) | 29.5 (52) | ||
25.5 (140) | 25.2 (41) | 28.7 (60) | 22.2 (39) | ||
7.3 (40) | 4.9 (8) | 5.3 (11) | 52.5 (21) | ||
59.2 (326) | 70.6 (115) | 47.4 (99) | 63.6 (112) |
Population demographic.
Community sensitization meetings were held during which information or explanations about the context of the study, its objectives, its methodological approach, and the associated ethical issues were provided. The signing of written informed consent was a requirement for all study participants, including the guardians of minor children.
Following consent, a clinical team of physicians and nurses examined all participants for clinical signs of malaria, measured weight, and axillary body temperature. Suspected malaria cases (T ≥ 37.5°C) were treated with artemether and lumefantrine.
During the first cross-sectional survey, a two (2) ml venous blood sample was collected from all participants in EDTA tubes.
Thick and thin blood smears were prepared and the hemoglobin level was measured by the HemoCue technique.
For each subject in this study, physical examination and capillary blood samples on slides and filter papers were collected. Slides were used for the diagnosis of malaria infection and the venous sampling was for the blood group characterization.
Blood slides were stained with Giemsa for microscope identification of the
Blood films were air-dried, the thin films fixed with methanol, and the slide stained with Giemsa. The slides were read by highly experienced laboratory technicians according to the site SOPs. Briefly, 100 high power fields were examined, and the number of malaria parasites/each species and stage was recorded. The number of parasites per microliter of blood was calculated assuming 200 white blood cells per high power field and a fixed white blood cell count of 8000/μL. A slide was considered negative if no parasites were found after the 100 HPF examination. Two independent microscopists read each slide and in case of discrepancy between the two readers, in terms of species, presence or absence of malaria parasites, or if the parasite densities differed by more than 30%, the slide was re-examined by a third laboratory technician. The arithmetic mean of the two closest readings was used as the final value of the parasite density. If there was no agreement after the third reading, the arithmetic mean of the three parasite densities was used.
DNA extraction from the buffy coat (about 1.5 ml in volume) was performed using Nucleon BACC2 Kits. Successful DNA extraction was checked on a 1% agarose gel stained with ethidium bromide. A total of 2235 DNA samples (about 50 μl in volume) were collected: 825 from Mossi, 877 from Fulani, and 533 from Rimaibè individuals. Samples were stored in screw cap tubes labeled with the study code. Samples were kept at −20°C in cryo boxes. The DNA samples were shipped to the WTCHG in Oxford, UK, in May 2008. The DNA samples of study participants were genotyped at the WTCHG in Oxford, UK.
Demographic variables collected during the census of the four villages include for each person; age, gender, father and mother ethnicity, village, compound, family members and sequential number within the family, and census code. Assignment of ethnicity has been performed with the assistance of local guides.
The census data file was anonymized (name identification has been removed for privacy protection) according to the study protocol which was approved by the ethical committee of Burkina Faso. Clinical data were matched to the census data with study enrolment codes. Case report forms (CRF) for cross-sectional surveys were verified by the supervisor of the clinical study before data entry. Similarly, parasitological data were verified by the lab supervisor before data entry. Data entry was conducted by a team of computer engineers at Ouagadougou, Burkina Faso, and data files were validated by the database manager.
Data were entered into Microsoft Access. A Chi-square test was used to assess the difference between frequencies/associations between blood groups and
Two-sided
The National Ethics Committee of the Ministry of Health (in Burkina Faso) granted ethical clearance. The study was conducted in compliance with the International Conference on Harmonization, Good Clinical Practices, the Declaration of Helsinki, and applicable Burkina Faso regulatory requirements. Individual written informed consent was obtained from each participant, participant’s parents, or legally acceptable representative.
This study aimed to investigate
A total of 548 subjects (380 children and 178 adults) were included in this study: Mossi, n = 163 (29.7%), Fulani, n = 209 (38.2%), and Rimaibe, n = 176 (32.1%). Table 2 shows baseline demographic characteristics according to ethnicity. We did not find any significant difference among the three ethnic groups. The ABO blood group analysis in all children revealed that O antigen: 40.5% (222/548) was the most predominant, followed by A: 25.5% (140/548), B: 26.6% (146/548), and AB: 7.3% (40/548) antigens. Blood group O was not only the commonest blood type overall, but was higher in the Fulani (n = 110 (52.6%)) than Mossi (n = 48 (29.4%)) and Rimaibe (n = 64 (36.4%)).
The malariometric indices for each cross-sectional survey are summarized in Table 3. The prevalence of
Malaria indices | *survey number | Total | Ethnic Group | P-value | ||||
---|---|---|---|---|---|---|---|---|
Mossi | Fulani | Rimaibe | F vs. M vs. R | F VS M | F vs. R | |||
Prevalence of Pf malaria Infection % (number positive/ total) | 1 | 283 (51.6) | 98 (60.1) | 91 (43.5) | 59 (52.7) | 0.08 | 0.025 | 0.30 |
2 | 236 (43.1) | 90 (55.2) | 54 (25.8) | 54 (48.2) | 0.002 | 0.003 | 0.00 | |
3 | 101 (18.4) | 33 (20.24) | 25 (12.0) | 26 (23.2) | 0.55 | 0.56 | 0.50 | |
4 | 272 (49.6) | 103 (63.2) | 69 (33.0) | 65 (58.0) | 0.0001 | 0.016 | 0.0001 | |
5 | 215 (39.2) | 87 (53.4) | 52 (24.9) | 47 (42.0) | 0.0056 | 0.0012 | 0.25 | |
Geometric mean of parasite density (p/μl) | 1 | 550 [441–687] | 865 [598–1252] | 374 [251–557] | 483 [331–708] | 0.021 | 0.001 | 0.316 |
2 | 313 [250–390] | 330 [228–478] | 297 [192–460] | 305 [211–441] | 0.932 | 0.634 | 0.050 | |
3 | 393 [289–536] | 230 [138–382] | 391 [195–780] | 572 [360–909] | 0.044 | 0.912 | 0.332 | |
4 | 264 [697–1040] | 685 [491–957] | 878 [578–1332] | 1030 [571–1414] | 0.253 | 0.036 | 0.51 | |
5 | 720 [563–920] | 791 [535–1167] | 523 [327–836] | 805 [520–1249] | 0.345 | 0.171 | 0.193 | |
Prevalence of clinical Pf cases % (number positive/total) | 1 | 52 (9.5) | 16 (9.8) | 18 (8.6) | 18 (10.2) | 0.98 | 0.88 | 0.78 |
2 | 13 (2.4) | 8 (4.9) | 4 (1.9) | 1 (0.1) | — | — | — | |
3 | 4 (0.7) | 0 (0.0) | 1 (0.5) | 3 (1.7) | — | — | — | |
4 | 31 (5.7) | 11 (6.7) | 9 (4.3) | 11 (6.3) | — | — | — | |
5 | 24 (4.4) | 13 (8.0) | 5 (2.4) | 6 (3.4) | — | — | — |
Malariometric indices according to the ethnicity group/survey.
Survey number.
1: First survey, the middle of high malaria transmission season (August 2008).
2: Second survey, the end of high malaria transmission season (Nov 2008).
3: Third survey, the middle of the dry low transmission season (March 2008).
4: The fourth survey, the start of the high transmission season (July 2008).
5: Fifth survey, the end of the high transmission season (November/December 2008).
The study showed that during the period of high transmission, there was an association between ethnicity and malaria infection (
Malaria indices | Survey number | Total | Ethnic group | P-value | |||||
---|---|---|---|---|---|---|---|---|---|
Mossi | Fulani | Rimaibe | F vs. M vs. R | F VS M | F vs. R | ||||
Prevalence of Pf malaria Infection % (number) | O | 98 (60.1) | 27 (56.3) | 46 (50.9) | 29 (45.3) | 0.724 | 0.64 | 0.60 | |
Non-O | 65 (39.9) | 71 (61.7) | 45 (45.5) | 59 (52.7) | 0.172 | 0.05 | 0.41 | ||
Non-O | A | 4.7 (5) | 27 (38.0) | 31 (33.7) | 22 (23.4) | 0.55 | 0.70 | 0.44 | |
B | 4.7 (5) | 41 (57.7) | 6 (6.6) | 24 (22.5) | 0.001 | 0.02 | 0.003 | ||
AB | 9.3 (10) | 3 (38.0) | 8 (8.8) | 13 (13.8) | — | — | — | ||
Geometric mean of parasite density (p/μl) [positive/ total] | O | 521 [359–755] | 1020 [486–2146] | 434 [237–767] | 373 [202–689] | 0.07 | 0.07 | 0.71 | |
Non-O | 569 [431–753] | 811 [525–1253] | 323 [188–555] | 563 [343–923] | 0.01 | 0.025 | 0.19 | ||
Non-O | A | 568 [382–845] | 1005 [489–2068] | 316 [167–599] | 595 [295–1205] | 0.04 | 0.012 | 0.173 | |
B | 535 [337–851] | 691 [393–1218] | 136 [23–822] | 494 [194–1260] | 0.16 | 0.04 | 0.19 | ||
AB | 680 [226–1561] | 928 [−] | 664 [128–3437] | 642 [204–2018] | 0.90 | 0.50 | 0.92 | ||
Prevalence of clinical Pf cases % (number positive/total) | O | 20 (9.0) | 4 (8.3) | 9 (8.2) | 7 (10.9) | — | |||
Non-O | 32 (9.8) | 12 (10.4) | 9 (9.1) | 11 (9.8) | — | ||||
Non-O | A | 7 (5.0) | 3 (7.3) | 3 (5.0) | 1 (2.6) | — | |||
B | 19 (13.0) | 8 (50.0) | 5 (27.8) | 4 (22.2) | — | ||||
AB | 6 (15.0) | 1 (12.5) | 1 (9.1) | 46 (19.6) | — | ||||
Prevalence of Pf malaria Infection % (number) | O | 39 (17.6) | 10 (20.8) | 12 (10.9) | 17 (26.6) | 0.38 | 0.86 | 0.36 | |
Non-O | 62 (19.0) | 23 (20.0) | 13 (13.1) | 26 (23.2) | 0.85 | 0.98 | 0.88 | ||
Non-O | A | 27 (19.3) | 11 (26.8) | 8 (13.3) | 8 (20.5) | 0.72 | 0.83 | 1.00 | |
B | 26 (17.8) | 11 (16.7) | 3 (10.7) | 12 (23.1) | — | — | — | ||
AB | 9 (25.5) | 1 (12.5) | 2 (18.2) | 6 (28.6) | — | — | — | ||
Geometric mean of parasite density (p/μl) [positive/ total] | O | 345 [207–575] | 185 [75–454] | 434 [237–767] | 483 [203–1143] | 0.18 | 0.34 | 0.57 | |
Non-O | 393 [288–536] | 253 [130–492] | 443 [149–1317] | 641 [360–1124] | 0.12 | 0.19 | 0.88 | ||
Non-O | A | 275 [152–495] | 172 [62–476] | 477 [96.1–2375] | 284 [144–558] | 0.33 | 0.20 | 0.42 | |
B | 533 [267–1064] | 337 [112–1014] | 185 [2.20–15,628] | 979 [348–2752] | — | — | — | ||
AB | 936 [447–1962] | 876 [−] | 1215 [0.0–1.7e09] | 855 [302–2419] | 0.075 | 0.46 | 0.052 | ||
Prevalence of clinical Pf cases % (number positive / total) | O | 1 (0.5) | 0 (0) | 0 (0) | 1 (1.6) | — | — | — | |
Non-O | 3 (0.9) | 0 (0.0) | 1 (0.0) | 1 (1.8) | — | — | — | ||
Non-O | A | 1 (0.7) | 0 (0.0) | 0 (0.0) | 1 (2.6) | — | — | — | |
B | 1 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.0) | — | — | — | ||
AB | 2 (5.0) | 0 (0) | 1 (9.1) | 1 (4.8) | — | — | — |
Malariometric indices according to the ethnicity and blood group/season.
F= Fulani; M= Mossi; R= Rimaibe; No-O = A + B + AB.
The subjects with Non-O blood (i.e. A, B, or AB) were less susceptible to malaria infection (
Blood group compared | All | Mossi | Fulani | Rimaibe |
---|---|---|---|---|
O vs. A | 0.028 | 0.17 | 0.12 | 0.49 |
O vs. B | 0.04 | 0.80 | 0.04 | 0.06 |
O vs. AB | 0.0067 | 0.90 | 0.11 | 0.13 |
O vs. (A + B + AB) | 0.011 | 0.56 | 0.59 | 0.49 |
O vs. A | 0.74 | 0.98 | 0.47 | 0.30 |
O vs. B | 0.91 | 0.34 | 0.18 | 0.57 |
O vs. AB | 0.53 | 0.71 | 0.52 | 0.33 |
O vs. (A + B + AB) | 0.000 | 0.58 | 0.52 | 0.29 |
O vs. A | 0.79 | 0.90 | — | 0.80 |
O vs. B | 0.84 | 0.65 | — | 0.87 |
O vs. AB | 0.85 | — | — | 0.73 |
O vs. (A + B + AB) | 0.86 | 0.72 | 0.94 | 0.91 |
O vs. A | 0.55 | 0.88 | 0.59 | 0.41 |
O vs. B | 0.28 | 0.34 | 0.53 | 0.27 |
O vs. AB | 0.08 | — | 0.27 | 0.47 |
O vs. (A + B + AB) | 0.55 | 0.58 | 0.69 | 0.09 |
The p values for the frequency of O and non-O blood group types between the three ethnic groups according to malaria infection and parasite density.
There was an association between the Non-O blood group of all ethnicities and malaria infections during high transmission. However, this association disappeared when the ethnic groups were considered separately (all ethnicities
This study revealed that blood group O represented the most observed phenotype among participants (40.5%), followed by blood group B (26.6%), then blood group A (25.5%), and finally the AB blood group, which is rarer (7.3%). These results are consistent with those of previous studies that reported a high frequency of group O phenotypes in areas endemic to malaria [5, 9, 10, 11, 12, 13].
Other studies have corroborated this evidence by the inverse relationship: they have reported a high prevalence of blood group A and a low prevalence of phenotypes of blood group O in colder regions where malaria is an exotic disease [5, 10, 14].
These results would confirm the hypothesis of a selective evolutionary advantage (survival) of
The results of this study according to ethnicity also showed that Fulani were less infected with malaria despite their way of life and living in the same conditions of hyperendemic transmission. These were comparable to observations in previous studies in Burkina Faso and West Africa [15, 16].
Like the study carried out in Gabon by Monbo et al. [17], this study showed a high prevalence of malaria infection in participants with blood group O compared to participants with blood groups A, B, or AB; and is in contrast to previous studies that suggested individuals of blood groups A, B, and AB is more susceptible to
Lower parasite densities in subjects of blood group O compared to non-O subjects were observed, but the differences were not statistically significant. These observations are in line with the conclusions of previous studies which have shown that patients with blood group O were associated with increased protection against parasitemia [18, 19, 20, 21, 22, 23].
These results would suggest a protective effect of the O antigen against clinical malaria. However, other explanations, such as the anti-rosette formation effect associated with blood group antigens, should also be considered [24].
In any case, this study made it possible to establish the involvement of Fulani groups against malaria infection and parasitemia. It also revealed that for all ethnicities combined, there would be a statistically significant difference in susceptibility to malaria between participants of blood groups O and participants of other blood groups (A, B, and AB).
The absence of any statistically significant difference in susceptibility to malaria in an intra-ethnic blood group analysis could be due to a sample size effect. Hence, the need for in-depth and broader epigenetic studies to accurately capture the effects of ABO blood groups in susceptibility to Pf malaria is highlighted.
The study confirmed that the Fulani group is less susceptible to
Evidence of correlations between ethnicity and blood group at risk of malaria infection would support the idea that the presumed association between blood group and malaria infection depends on the demographic distribution and characteristics of the population studied. As a result, each region of the world has a characteristic ABO phenotypic distribution, making it urgent to fully understand the biology of malaria infection through detailed studies of the interactions between the ABO blood grouping system: A critical condition for saving lives in malaria-endemic regions.
The authors have declared no conflict of interest.
BEC wrote the manuscript and agree to be accountable for all aspects of the work.
AO and SBS read and approved the final manuscript and agree to be accountable for all aspects of the work.
The study received approval from the ethical committees of the Ministry of Health of Burkina Faso.
Groupe de Recherche Action en Santé
Group Sanguin (O, A, B, AB)
Red Blood Cells
World Health Organization
IntechOpen publishes different types of publications
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He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. 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(Eng.) in Telematics from the Universidad de Colima, Mexico. He obtained both his M.Sc. and Ph.D. from the University of Liverpool, England, in the field of Intelligent Systems. He is a full professor at the Universidad Autonoma de Queretaro, Mexico, and a member of the National System of Researchers (SNI) since 2009. Dr. Aceves Fernandez has published more than 80 research papers as well as a number of book chapters and congress papers. He has contributed in more than 20 funded research projects, both academic and industrial, in the area of artificial intelligence, ranging from environmental, biomedical, automotive, aviation, consumer, and robotics to other applications. He is also a honorary president at the National Association of Embedded Systems (AMESE), a senior member of the IEEE, and a board member of many institutions. 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. He is also a Clinical Assistant Professor at the SUNY Downstate University Hospital and Adjunct Professor of Medicine at the American University of Antigua. He is a holder of an M.B.B.S. degree bestowed to him by Osmania Medical College and received his M.D. at Interfaith Medical Center. His career goals thus far have heavily focused on direct patient care, medical education, and clinical research. He currently serves in two leadership capacities; Assistant Program Director of Medicine at Interfaith Medical Center and as a Councilor for the American\r\nFederation for Medical Research. As a true academician and researcher, he has more than 50 papers indexed in international peer-reviewed journals. He has also presented numerous papers in multiple national and international scientific conferences. His areas of research interest include general internal medicine, gastroenterology and hepatology. He serves as an editor, editorial board member and reviewer for multiple international journals. His research on Hepatitis C has been very successful and has led to multiple research awards, including the 'Equity in Prevention and Treatment Award” from the New York Department of Health Viral Hepatitis Symposium (2018) and the 'Presidential Poster Award” awarded to him by the American College of Gastroenterology (2018). He was also awarded 'Outstanding Clinician in General Medicine” by Venus International Foundation for his extensive research expertise and services, perform over and above the standard expected in the advancement of healthcare, patient safety and quality of care.",institutionString:"Interfaith Medical Center",institution:{name:"Interfaith Medical Center",country:{name:"United States of America"}}},{id:"93517",title:"Dr.",name:"Clement",middleName:"Adebajo",surname:"Meseko",slug:"clement-meseko",fullName:"Clement Meseko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/93517/images/system/93517.jpg",biography:"Dr. Clement Meseko obtained DVM and PhD degree in Veterinary Medicine and Virology respectively. He has worked for over 20 years in both private and public sectors including the academia, contributing to knowledge and control of infectious disease. Through the application of epidemiological skill, classical and molecular virological skills, he investigates viruses of economic and public health importance for the mitigation of the negative impact on people, animal and the environment in the context of Onehealth. \r\nDr. Meseko’s field experience on animal and zoonotic diseases and pathogen dynamics at the human-animal interface over the years shaped his carrier in research and scientific inquiries. He has been part of the investigation of Highly Pathogenic Avian Influenza incursions in sub Saharan Africa and monitors swine Influenza (Pandemic influenza Virus) agro-ecology and potential for interspecies transmission. He has authored and reviewed a number of journal articles and book chapters.",institutionString:"National Veterinary Research Institute",institution:{name:"National Veterinary Research Institute",country:{name:"Nigeria"}}},{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. Dr. Saxena is a fellow of various international societies/academies including the Royal College of Pathologists, United Kingdom; Royal Society of Medicine, London; Royal Society of Biology, United Kingdom; Royal Society of Chemistry, London; and Academy of Translational Medicine Professionals, Austria. He was named a Global Leader in Science by The Scientist. He is also an international opinion leader/expert in vaccination for Japanese encephalitis by IPIC (UK).",institutionString:"King George's Medical University",institution:{name:"King George's Medical University",country:{name:"India"}}},{id:"94928",title:"Dr.",name:"Takuo",middleName:null,surname:"Mizukami",slug:"takuo-mizukami",fullName:"Takuo Mizukami",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94928/images/6402_n.jpg",biography:null,institutionString:null,institution:{name:"National Institute of Infectious Diseases",country:{name:"Japan"}}},{id:"233433",title:"Dr.",name:"Yulia",middleName:null,surname:"Desheva",slug:"yulia-desheva",fullName:"Yulia Desheva",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/233433/images/system/233433.png",biography:"Dr. Yulia Desheva is a leading researcher at the Institute of Experimental Medicine, St. Petersburg, Russia. 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