Abstract
The clinical outcome of falciparum malaria in endemic areas is influenced by erythrocyte polymorphisms including the ABO blood groups. Studies have reported association of ABO blood group to resistance, susceptibility, and severity of P. falciparum malaria infection. Individuals with blood group “A” have been found to be highly susceptible to falciparum malaria whereas blood group “O” is said to confer protection against complicated cases. We analyzed samples from 293 young children less than six years old with malaria in the Korle-Bu Teaching Hospital in Accra, Ghana. It was observed that group O was present in about 16.1% of complicated cases weighed against 40.9% of uncomplicated controls. Individuals with complicated malaria were about twice likely to be of blood groups A and B compared to group O (A versus O, OR = 1.90, 95% CI = 1.59–2.26, P < 0.0001; B versus O, OR = 1.82. 95% CI = 1.57–2.23, P < 0.0001). Blood group O participants with complicated diseases had low parasitaemia compared to the other blood groups (P < 0.0001). This may give blood group O individuals a survival advantage over the other groups in complicated malaria as suggested. Participants with complicated falciparum malaria were generally anaemic and younger than those with uncomplicated disease.
Highlights
Plasmodium falciparum malaria is a known cause of morbidity and mortality especially in children of Sub-Saharan Africa [1]
Respondents in the complicated group were younger and anaemic and experienced higher parasitaemia compared with their counterparts in the uncomplicated group (P < 0.05; Table 1)
Our data supported this notion since participants who had complicated falciparum malaria were significantly younger than those who had uncomplicated disease
Summary
Plasmodium falciparum malaria is a known cause of morbidity and mortality especially in children of Sub-Saharan Africa [1]. The clinical outcome of falciparum malaria in endemic areas is, among other factors, associated with erythrocyte polymorphisms [2, 3] including the ABO blood groups. ABO blood group refers to a system of carbohydrate antigens expressed on human erythrocytes [4] and other human cells. The “A” and “B” antigens on erythrocytes are trisaccharides [5]. All erythrocytes possess an “H” disaccharide on their surfaces (except the rare Bombay phenotype, which has no ABO antigens) [4]. Individuals with blood groups “A” and “B” have the “A” and “B” antigens, respectively, together with the “H” antigen. Blood group “AB” individuals have both “A” and “B” antigens together with the “H.” Blood group “O”
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