International Journal of Research and Reports in Hematology

Disparities in the Susceptibilities of ABO and Rh Blood Antigens to Severe Plasmodium falciparum in Children Under Five Years; A Cross-Sectional Study among Rural Dwellers, North East Region, Ghana

Charles Nkansah *

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana and Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria.

Felix Osei-Boakye

Department of Medical Laboratory Technology, Faculty of Applied Science and Technology, Sunyani Technical University, Sunyani, Ghana.

Samuel K. Appiah

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana and Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria.

Kofi Mensah

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana and Department of Medical Laboratory Sciences, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria.

Samira Daud

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Vital G. Abuku

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Gabriel Abbam

Department of Haematology, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Dorcas Serwaa

Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.

Charles A. Derigubah

Department of Medical Laboratory Technology, School of Applied Science and Arts, Bolgatanga Technical University, Bolgatanga, Ghana.

Simon B. Bani

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Hisham Alhassan Osumanu

Department Infectious Diseases, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Thea Kangkpi

Department Infectious Diseases, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Yeduah Quansah

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Francis Atoroba Apodola

Department of Medical Laboratory Science, Faculty of Allied Health Sciences, College of Nursing and Allied Health Sciences, Nalerigu, Ghana

Michael O. Tetteh

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Candy Adwoa Ewusiwaa Wilson

Department of Biomedical Laboratory Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.

Richard V. Duneeh

Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana.

*Author to whom correspondence should be addressed.

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Abstract

Aim: To determine the association between ABO and Rh blood antigens, and severe Plasmodium falciparum malaria among children under five years.

Study Design: Hospital-based cross-sectional study

Place and Duration of Study: Janga District Hospital, North East Ghana from April to August, 2022.

Methodology: The study recruited 410 children below five years of age. Three millilitres of venous blood were collected from each participant for haemoglobin (Hb) estimation, thick and thin blood films for malaria parasites, and blood antigen determination. The data were analyzed with STATA version 16.0 and P<.05 was considered statistically significant.

Results:  About one-third (32.68%) of the participants had severe Plasmodium falciparum malaria, and 264 (64.39%) had uncomplicated malaria. Blood group O Rh ‘D’ Positive (O+) was the most predominant blood antigen. Severe malaria commonly occurred in A Rh ‘D’ Positive (A+), 54/134 (40.30%) subjects compared to  the other blood groups, while uncomplicated malaria was highest in the O+ group, 150/264 (56.82%). Complicated malaria patients were about seven times, and thrice likely to be of blood groups A+ and B Rh ‘D’ Positive (B+), respectively compared to blood group O+ (A+ vs O+: OR=7.60, 95% CI:4.27-13.51, p<.001; B+ vs O+: OR=3.11, 95% CI: 1.80-5.37, p<.001).

Conclusion: The study identified a relatively higher prevalence of P. falciparum malaria in children below five years in the Janga district. About one-third of the participants had severe malaria. Individuals with blood groups A+ and B+ are more susceptible to severe P. falciparum infection than those with blood type O+. Incorporation of blood antigen determination into the routine management of malaria is recommended.

Keywords: ABO and Rh antigens, Plasmodium falciparum, parasitaemia, susceptibilities, thick and thin blood films

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