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Previous studies have attempted to address the roles of parasite adhesion and biomass in disease severity; however, these studies have been limited to single geographical sites, and there is limited understanding of how parasite adhesion and biomass interact to influence disease manifestations. In this meta-analysis, we compared parasite disease determinants in African children and Indian adults. This study demonstrates that parasite biomass and specific subsets of\n            <jats:italic>var<\/jats:italic>\n            genes are independently associated with detrimental outcomes in both childhood and adult malaria. We also explored how parasite\n            <jats:italic>var<\/jats:italic>\n            adhesion types and biomass play different roles in the development of specific severe malaria pathologies, including childhood cerebral malaria and multiorgan complications in adults. 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