Abstract
BackgroundMalaria clinical outcomes vary by erythrocyte characteristics, including ABO blood group, but the effect of ABO blood group on asymptomatic, uncomplicated and placental Plasmodium falciparum (P. falciparum) infection remains unclear. We explored effects of ABO blood group on asymptomatic, uncomplicated and placental falciparum infection in the published literature.MethodsA systematic review and meta-analysis was performed using the preferred reporting items for systematic reviews and meta-analyses guidelines. Articles in Pubmed, Embase, Web of Science, CINAHL and Cochrane Library published before February 04, 2017 were searched without restriction. Studies were included if they reported P. falciparum infection incidence or prevalence, stratified by ABO blood group.ResultsOf 1923 articles obtained from the five databases (Embase = 728, PubMed = 620, Web of Science = 549, CINAHL = 14, Cochrane Library = 12), 42 met criteria for systematic review and 37 for meta-analysis. Most studies (n = 30) were cross-sectional, seven were prospective cohort, and five were case-control studies. Meta-analysis showed similar odds of uncomplicated P. falciparum infection among individuals with blood group A (summary odds ratio [OR] 0.96, 15 studies), B (OR 0.89, 15 studies), AB (OR 0.85, 10 studies) and non-O (OR 0.95, 17 studies) as compared to those with blood group O. Meta-analysis of four cohort studies also showed similar risk of uncomplicated P. falciparum infection among individuals with blood group non-O and those with blood group O (summary relative risk [RR] 1.03). Meta-analysis of six studies showed similar odds of asymptomatic P. falciparum infection among individuals with blood group A (OR 1.05), B (OR 1.03), AB (OR 1.23), and non-O (OR 1.07) when compared to those with blood group O. However, odds of active placental P. falciparum infection was significantly lower in primiparous women with non-O blood groups (OR 0.46, 95% confidence interval [CI] 0.23 – 0.69, I2 0.0%, three studies), particularly in those with blood group A (OR 0.41, 95% CI 0.003 – 0.82, I2 1.4%, four studies) than those with blood group O.ConclusionsThis study suggests that ABO blood group may not affect susceptibility to asymptomatic and/or uncomplicated P. falciparum infection. However, blood group O primiparous women appear to be more susceptible to active placental P. falciparum infection.
Highlights
Malaria clinical outcomes vary by erythrocyte characteristics, including ABO blood group, but the effect of ABO blood group on asymptomatic, uncomplicated and placental Plasmodium falciparum (P. falciparum) infection remains unclear
Asymptomatic P. falciparum infection may not cause any significant health problems, the parasite can persist in the blood for several months and produce gametocytes that can serve as a source of infection for the vector [5, 6]
We examined references cited in reviews of malaria and ABO blood group for additional articles [9, 10]
Summary
Malaria clinical outcomes vary by erythrocyte characteristics, including ABO blood group, but the effect of ABO blood group on asymptomatic, uncomplicated and placental Plasmodium falciparum (P. falciparum) infection remains unclear. We explored effects of ABO blood group on asymptomatic, uncomplicated and placental falciparum infection in the published literature. Malaria caused due to Plasmodium falciparum infection remains a major cause of death in tropical and subtropical countries [1, 2]. Individuals infected with P. falciparum may present with mild (e.g. fever, chills, headaches, nausea, malaise) or severe clinical symptoms (e.g. pulmonary edema, cerebral malaria, acute renal failure, severe anemia) [3, 4]. Some individuals may have P. falciparum parasitemia, but not show symptoms suggestive of Plasmodium infection (asymptomatic parasitemia) [5, 6]. Asymptomatic infection contributes to the maintenance of malaria transmission in endemic regions [5, 6]
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