Abstract
BackgroundGenetic diversity of ABO blood, glucose-6-phosphate dehydrogenase (G6PD) deficiency and haemoglobin type and their ability to protect against malaria vary geographically, ethnically and racially. No study has been carried out in populations resident in malaria regions in western Kenya.MethodA total of 574 malaria cases (severe malaria anaemia, SMA = 137 and non-SMA = 437) seeking treatment at Vihiga County and Referral Hospital in western Kenya, were enrolled and screened for ABO blood group, G6PD deficiency and haemoglobin genotyped in a hospital-based cross-sectional study.ResultWhen compared to blood group O, blood groups A, AB and B were not associated with SMA (P = 0.380, P = 0.183 and P = 0.464, respectively). Further regression analysis revealed that the carriage of the intermediate status of G6PD was associated with risk to SMA (OR = 1.52, 95%CI = 1.029–2.266, P = 0.035). There was, however, no association between AS and SS with severe malaria anaemia. Co-occurrence of both haemoglobin type and G6PD i.e. the AA/intermediate was associated with risk to SMA (OR = 1.536, 95%CI = 1.007–2.343, P = 0.046) while the carriage of the AS/normal G6PD was associated with protection against SMA (OR = 0.337, 95%CI = 0.156–0.915, P = 0.031).ConclusionResults demonstrate that blood group genotypes do not have influence on malaria disease outcome in this region. Children in Vihiga with blood group O have some protection against malaria. However, the intermediate status of G6PD is associated with risk of SMA. Further, co-inheritance of sickle cell and G6PD status are important predictors of malaria disease outcome. This implies combinatorial gene function in influencing disease outcome.
Highlights
Genetic diversity of ABO Blood group system (ABO) blood, glucose-6-phosphate dehydrogenase (G6PD) deficiency and haemoglobin type and their ability to protect against malaria vary geographically, ethnically and racially
A total of 574 children were enrolled into this study comprising of 137 with Severe Malaria Anaemia
This study reveals that blood groups do not have a significant influence on malaria disease outcome
Summary
Genetic diversity of ABO blood, glucose-6-phosphate dehydrogenase (G6PD) deficiency and haemoglobin type and their ability to protect against malaria vary geographically, ethnically and racially. Africa continues to account for about 90% of all malaria cases and deaths worldwide [1] This high rates of malaria related morbidities is greatly driven by the malaria vaccine escape and drug resistant mutants resulting from host immune and drug pressure [2]. Rosetting is characterized by the binding of P. falciparum-infected red blood cells to uninfected red blood cells to form clusters of cells that are thought to contribute to the pathology of falciparum malaria by obstructing blood flow in small blood vessels [4] Rosetting parasites such as P. falciparum form larger, stronger rosettes in non-O (A, B or AB) blood groups than in group O red blood cells [5, 6] suggesting that rosetting phenotypes correlates with severe falciparum malaria [7]. Some studies have reported the absent of significant association between ABO blood group and malaria [8] while others have reported high frequency of malaria episodes in blood group A, AB, and B compared with other blood group individuals [9]
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