2 20 ABSTRACT 21 Recent research efforts to identify genes involved in the susceptibility to P. falciparum malaria have 22 focused on severe forms of malaria, with several genome-wide association studies (GWAS) and 23 multi-center analyses published this past decade. Here we present the first GWAS performed on 24 mild malaria susceptibility in young children, designed to identify genetic variants involved in 25 innate immunity or innate resistance mechanisms. Two cohorts of infants from southern Benin (525 26 and 250 individuals respectively), used as discovery and replication cohorts, were closely followed 27 from birth to 18-24 months of age, with an assessment of a space-and time-dependent risk of 28 exposure to vector bites. GWAS was performed on 15.5 million genotyped and imputed variants, 29 with the susceptibility of infants to mild malaria attacks and to malaria infections as a whole (both 30 symptomatic and asymptomatic). Infant susceptibility to malaria was assessed by considering all 31 malaria events occurring during the follow-up using a Cox-model for recurrent events. We found 32 strong statistical support for a role of PTPRT, a tyrosine phosphatase receptors involved in STAT3 33 pathway, with the protection against both mild malaria attacks and malaria infections (p=9.70x10 -8 34 and p=1.78x10 -7 respectively in the discovery cohort, and both p < 0.05 in the replication cohort).35 Furthermore, our study highlights several other genes, among them, UROC1, ACER3 and the 36 PLAG2 cluster, whose biological functions are relevant in malaria infection. Results show that 37 despite the difficulty of setting up such longitudinal field studies, GWAS on non-severe malaria can 38 successfully identify new candidate genes and inform physiological mechanisms underlying natural 39 protection against malaria. 40 41 AUTHOR SUMMARY 42 Malaria remains a major worldwide public health problem with circa 219 million cases and 435,000 43 deaths per year. As for many infectious diseases, the genetics of the host plays a role in the disease 44 course. So far, most studies on such genetic factors focused on severe malaria forms. Our study 45 aimed to find factors associated with simple forms (asymptomatic forms and uncomplicated clinical 3 46 forms). We used dense genome-wide data of two cohorts of infants closely followed during two 47 years in Benin, and we incorporated an environmental risk of exposure estimated at individual level 48 from entomological, climatic, and environmental data. This allowed us to unravel several genes that 49 appear to play a role in the susceptibility to malaria infection, thus demonstrating the feasibility of a 50 genome-wide approach on non-severe forms. Functional studies are needed to confirm the role of 51 the genetic factors highlighted here. Some of these genes represent interesting targets for future 52 prevention strategies and drug development. 4 53 INTRODUCTION 54 55 In spite of numerous prevention and control efforts in recent years, malaria remains a major 56 global public health ...