Rhesus Typing Research Articles

Epidemiology of congenital malformations in Tunisian liveborns: a retrospective study

Objective: To identify the various congenital malformations in liveborns in the neonatology service within the center of maternity and neonatology of Tunis (CMNT). Methods: This is a retrospective study of liveborns with congenital malformations hospitalized during one year from 1rst January to 31 December 2016. Results: The profile of malformations was dominated by polymalformations (22.29%), followed by chromosomal aberrations (21.14%), cardiovascular malformations (16.00%), and system nervous malformations (11.43%). Comparisons of liveborns and parental characteristics between all congenital malformations subtypes have shown significant differences in liveborns sex, consanguinity, and maternal age. Comparisons between malformed newborns and malformed fetuses have shown significant differences in consanguinity, rhesus type, maternal origin and parity. Conclusion: It seems important to set a careful surveillance of pregnancies at risk of developing congenital anomalies, systematic supplementation of vitamins and folic acid, and a national registry of congenital malformations. Keywords: Congenital malformations; liveborns; risk factors; prevention; Tunisia.

Clinical assessment of ectopic pregnancy in a tertiary care hospital: An observational study

Background: Ectopic pregnancy is defined as pregnancy that occurs outside normal uterine cavity that occurs due to implantation of fertilized ovum in an aberrant site which is conducive to its growth and development. In developing countries like India, late presentations with tubal rupture and hemodynamic instability, late presentations with tubal rupture causes first trimester maternal morbidity and mortality. For early diagnosis, a clinician should be well aware about the various presentations of ectopic pregnancy. Aims and Objectives: (a) To estimate the incidence, risk factors, clinical manifestations and outcome following different management protocol. (b) To estimate the morbidity and mortality with respect to different types of presentation and management. (c) To understand the need for clinical assessment in order to diagnose early and provide urgent intervention and also to lean toward the possibility of conservative approach in order to preserve fertility. Materials and Methods: The current study was a time bound, Observational descriptive study with Longitudinal design. It was conducted in the Department of Obstetrics and Gynecology, R. G. Kar Medical College and Hospital, between March 2021 and August 2022. One hundred and thirty-eight participants, suspected to have ectopic pregnancy were enrolled for the study. Data collection was done by detailed history taking and physical examination. The basic investigations including hemoglobin, ABO and Rhesus typing, urine pregnancy test, and ultrasound (USG) examination were done. All data were collected on a structural data form and analyzed for descriptive statistics. Post-operative histopathological examination (HPE) reports were collected and final diagnosis was made. Results: About 63.8% of the study population belonged to 21–30 years of age. About 63.7% patients presented with >5–8 weeks of amenorrhea. About 18.1% of the study population were sterilized and the duration between the sterilization and the occurrence of ectopic was 4–10 years in 64% patients. The most common risk factor was h/o Previous C-section (31.8%). The most common clinical symptom was abdominal pain present in 131 (94.9%), 44 (31.9%) participants had all the three classical symptoms with 100% specificity. On examination, forniceal fullness/tenderness was the most specific finding. The most common USG finding was Adnexal mass with empty Uterine cavity with Free fluid (49.2%). Most of the patients were managed with Partial Salpingectomy (30.4%). The final diagnosis of ectopic was made in 129 patients, which was confirmed by HPE reports in 124 patients. Five patients underwent medical treatment. Conclusion: Early diagnosis before rupture and referral are the key factor in reducing the maternal morbidity and mortality.

Impact of the blood group on postoperative CRP and leukocyte levels after primary total hip and knee arthroplasty.

C-reactive protein (CRP)- and leukocyte levels are common parameters to evaluate the inflammatory response after orthopaedic surgery and rule out infectious complications. Nevertheless, both parameters are vulnerable to disturbing biases and therefore leave room for interpretation. Since blood groups are repeatedly discussed to influence inflammatory response, our aim was to observe their impact on CRP and leukocyte levels after total hip and knee arthroplasty (THA/TKA). Short term postoperative CRP and leukocyte levels of 987 patients, who received either primary TKH (n= 479) or THA (n= 508), were retrospectively correlated with their blood group. ABO, Rhesus and a combination of both blood groups were differentiated. CRP levels after TKA were significantly higher in blood type AB than in type A and O on day 2-4 and also than in type A on day 6-8. Leukocyte levels after THA were significantly higher in blood group type O than in type A on day 6-8 while still remaining in an apathological range. We observed no significant differences between Rhesus types and Rhesus types and CRP or leukocyte levels. We observed significantly increased CRP levels after TKA in patients with blood group AB. Since the elevated CRP levels do not account for early periprosthetic infection, surgeons should include this variation in their postoperative evaluation.

Irregular Antibody Screening Using a Microdroplet Platform.

The screening procedure for antibodies is considered the most tedious among the three pretransfusion operations, i.e., ABO and Rhesus (Rh) typing, irregular antibody screening/identification, and crossmatching tests. The commonly used screening method for irregular antibodies in clinics at present is a manual polybrene test (MP). The MP test involves numerous reagent replacement and centrifuge procedures, and the sample volume is expected to be relatively less. Herein, screening red blood cells (RBCs) and serum irregular antibodies are encapsulated in microdroplets with a diameter of ~300 μm for a hemagglutination reaction. Owing to the advantage of spatial limitation in microdroplets, screening RBCs and irregular antibodies can be directly agglutinated, thereby eliminating the need for centrifugation and the addition of reagents to promote agglutination, as required by the MP method. Furthermore, the results for a large number of repeated tests can be concurrently obtained, further simplifying the steps of irregular antibody screening and increasing accuracy. Eight irregular antibodies are screened using the proposed platform, and the results are consistent with the MP method. Moreover, the volume of blood samples and antibodies can be reduced to 10 μL and 5 μL, respectively, which is ten times less than that using the MP method.

Distribution of ABO and Rhesus Types in the Northern Asir Region in Saudi Arabia.

The ABO blood group system is used to denote the presence of one, both, or neither of the A and B antigens on erythrocytes. In humans, this is the most important of the 43 different blood type (or group) classification systems currently recognized. Distribution of ABO and Rh among the Saudi population could affect many factors such as blood transfusion, prognosis, resistance and susceptibility to diseases. The impetus of this study was to develop an understanding of the distribution of the ABO and Rh types of healthy volunteer blood donors in the northern Asir region of Saudi Arabia, comparing the findings to similar studies. Understanding the frequency of different blood types in different populations is imperative. This study was performed during the period of January 1, 2020, to December 31, 2020, using samples from 4167 voluntary subjects obtained from the blood bank of the King Abdullah Hospital, Bisha. Commercially provided anti-A, anti-B and anti-D antibodies were used for the standard blood grouping procedure. The findings in this study showed that O was the most prominent ABO blood group, whereas AB was the least so. The frequency of the blood type A was the second highest, followed by the blood group B, whereas Rh positivity was more common than Rh negativity. O+ > A+ > B+ > O-> AB+> A-> B- > AB- was found to be the order of blood group frequency in the current study.

The Clinical Utility of ABO and RHD Systems as Potential Indicators of Health Status, a Preliminary Study in Greek Population.

Objective: The objective of this study is to further highlight the differences between different ABO blood groups and Rhesus types with health biomarkers. Methods: In total 150 active healthy blood donors participated in our study comprising of 80 males from 19–61 years and 70 females aged from 21 to 64. Participants carrying blood group A were 55 individuals, blood group B 32, blood group O 51, and blood group AB 12, RHD+ 132, and RHD- 18. All the volunteer regular blood donors were selected recognizing them as a healthy population excluding drug and supplements intake. Their blood samples were analyzed just before blood donation for biochemical, hematological, and antioxidant markers. Statistical computations were performed using the SPSS tool, specifically, the one-way ANOVA test, Chi-square statistics, and logistic regression were used as statistical models. Results: O blood donors presented better iron absorption and the worst lipid profile. Indeed, a significant trend of high atheromatic index values revealed an increased risk for hyperlipidemia, in contrast with blood group A presenting a better lipid profile with lower atheromatic index values. There was also a gender related association for blood group A compared with O that was further highlighted using binary logistic regression. Conclusion: In this study, a significant difference was observed among the ABO blood groups in several of the examined biochemical and hematological biomarkers. O blood group appeared different behavior in comparison to all the tested blood groups and furthermore the RHD-group presented a better lipid profile in comparison to the RHD+ group. In order to obtain a more comprehensive view of the correlation between the ABO blood group and biochemical markers, further studies are required.

Confirmed non-invasive prenatal testing for foetal Rh blood group genotyping along with bi-allelic short insertion/deletion polymorphisms as a positive internal control.

Determination of foetus rhesus blood group at risk of hemolytic disease has potential application for early non-invasive prenatal testing (NIPT). There are several challenges in developing NIPT rhesus blood group genotyping assays by using cell-free foetal DNA (cff-DNA) in plasma of RhD-negative pregnant women. So, the aim of this study was optimization of Real-time PCR assay for NIPT rhesus genotyping and development of Bi-allelic short insertion/deletion polymorphisms (INDELs) as internal control to optimise and validate rhesus genotyping based on Real-time PCR to avoid false or negative results. NIPT Rhesus genotyping including RHD (exon 7), RHCc, and RHEe genes were performed by TaqMan Real-time PCR on 104 maternal samples at different gestation ages (12 to ≥40 weeks) from 51 alloimmunized pregnant women. The sensitivity protocol was confirmed with standard DNA samples. Eight selected INDELs were designed and used to detectable cff-DNA in maternal plasma. INDELs frequency and inheritance were determined on 6 family and 61 unrelated individuals. Finally, multiplex Real-time PCR was performed for each sample with INDELs pairs and Rh probes. The results showed 100% accuracy rhesus typing for RHD, RHC and RHE assays and 95.7% accuracy for RHc. Also, eight selected INDELs as internal control for NIPT were 100% concordance for typed samples. The Real-time PCR assay is a suitable method with high sensitivity and specificity for rhesus typing as NIPT for prediction of hemolytic disease in foetuses. The INDELs described here are suitable internal control for confirmation of NIPT on cff-DNA.

The Potential Impact of Blood System on Dietary Habits and Smoking.

The ‘Blood-Type’ diet advises individuals to eat according to their ABO blood group to improve their health and decrease the risk of chronic diseases. However, the food preferences of individuals with different blood groups have not been examined. The aim of our study was to investigate, in healthy regular blood donors (rBDs), the associations of smoke, alcohol, caffeine, vitamin and fat intake with their different blood groups and if ABO groups could be a potential predictor tool for disease prevention. A total of 329 volunteers were divided into four groups according to their ABO types: Group 1 (A) comprised 141 rBDs; Group 2 (B), 65 rBDs; Group 3 (O), 96 rBDs; and Group 4, 27 rBDs. Additionally, they were divided into two groups according to their rhesus types and their preferences for smoke, too. Dietary intake was assessed using 3-day food recall and the Food Processor computer program for nutrient analysis. Alcohol, caffeine, sugar and Vitamin D consumption were significantly (p < 0.05) higher in the O group. The A group presented statistically significantly (p < 0.05) greater preferences for cholesterol intake and a higher trend for smoking (25%) habits compared with all the other groups, whereas Group B preferred more fatty foods. The blood group AB appeared to be the most controlled food intake group. Regarding the rhesus comparisons, alcohol; caffeine; and Vitamin C, D, E and K consumptions were significantly (p < 0.05) higher in rhesus-positive individuals than their rhesus-negative counterparts. For the non-smoker group, compared with the smokers, a higher consumption of Vitamin D and fibers was found. In conclusion, in the present study, statistically significant correlations of the ABO and rhesus system with some dietary parameters were found, indicating a consequent influence of these preferences on the progression of different diseases.

A Retrospective Review of the Effect of COVID-19 Pandemic on Laboratory Utilization

Introduction/ObjectiveWe performed a retrospective analysis of test volumes in clinical pathology prior to and during the COVID-19 pandemic to better understand the impact of the pandemic on our laboratory utilization.Methods/Case ReportThe laboratory information system was queried for test order volume in 2019 and 2020 using Discern Analytics 2.0. Representative tests including C-reactive protein (CRP), D-dimer, fibrinogen, ferritin, lactate dehydrogenase (LDH), procalcitonin, prothrombin time (PT), point of care iSTAT blood gas analysis, ABO and Rhesus typing (ABORh), antibody screening, flow cytometry, and serum protein electrophoresis (SPEP). Data was analyzed using Microsoft Excel 2013.Results (if a Case Study enter NA)The data showed an increase in the number of tests ordered and verified in the in-patient setting. The increase was most substantial for D-dimer, CRP and LDH with a percentage increase of approximately 200% on each test from year 2019 to 2020. An increase of 73% and 57% was noted for ferritin and fibrinogen respectively. A slight decrease in volume was noted for tests ordered in the out-patient setting including SPEPs during the pandemic. There was no significant change in the number of orders verified for point of care ISTAT blood gas testing between 2019 and 2020. Procalcitonin test volume increased steadily from its implementation in May 2020 with a steep rise in test volume in November and December. A total of 75,295 SARS-CoV-2 molecular tests were ordered between March and December 2020 with approximately 80% of the orders being performed as a send- out test.ConclusionThe COVID-19 pandemic has had a substantial impact on laboratory utilization with significant volume increases in tests that guide the management of hospitalized COVID-19 patients and slight decrease in tests ordered mostly in the outpatient setting. These results may help guide current and future decisions relating to laboratory operations during pandemics.

A cross-sectional study to evaluate antenatal care service provision in 3 hospitals in Nepal

BACKGROUNDGlobally, many mothers and their babies die during pregnancy and childbirth. A key element of optimizing outcomes is high-quality antenatal care. The Government of Nepal has significantly improved antenatal care and health outcomes through high-level commitment and investment; however, only 69% of patients attend the 4 recommended antenatal appointments.OBJECTIVEThis study aimed to evaluate the quality and perceptions of antenatal care in Nepal to understand compliance with the Nepalese standards.STUDY DESIGNThis cross-sectional study was conducted at a tertiary referral and private hospital in Kathmandu and a secondary hospital in Makwanpur, Nepal. The study recruited 538 female inpatients on postnatal wards during the 2-week data collection period from May 2019 to June 2019. A review of case notes and verbal survey of women to understand the pregnancy information they received and their satisfaction with antenatal care were performed. We created a summary score of the completeness of antenatal care services received ranging from 0 to 50 (50 indicating complete conformity with standards) and investigated the determinants of attending 4 antenatal care visits and patient satisfaction.RESULTSThe median antenatal care attendance was 4 visits at the secondary and referral hospitals and 8 visits at the private hospital. However, 24% of the patients attended <4 visits. Furthermore, 117 of 538 patients (22%) attended the first-trimester visit, and 65 of 538 patients (12%) attended visits at all points recommended in the standards. More than 90% of the women had blood pressure monitoring, hemoglobin estimation, blood grouping and Rhesus typing, and HIV and syphilis screening. Approximately 50% of the women had urinalysis at every visit (interquartile range, 20–100). Moreover, 509 of 538 patients (95%) reported receiving pregnancy information, but retention was variable: 509 of 538 patients (93%) received some information about danger signs, 290 of 502 patients (58%) remembered headaches, and 491 of 502 patients (98%) remembered fluid leaking. The antenatal care completeness score revealed that the private hospital offered the most complete clinical services (mean, 28.7; standard deviation, 7.1) with the secondary hospital performing worst (mean, 19.1; standard deviation, 7.1). The factors influencing attendance at 4 antenatal care visits in the multivariable model were beginning antenatal care in the first trimester of pregnancy (odds ratio, 2.74; 95% confidence interval, 1.36–5.52) and having a lower level of education (no school: odds ratio, 0.46 [95% confidence interval, 0.23–0.91]; grades 1–5: odds ratio, 0.49 [95% confidence interval, 0.26–0.92]). Overall, 303 of 538 women (56%) were satisfied with their antenatal care. The multivariable analysis revealed that satisfaction was more likely in women attending the private hospital than in women attending the referral hospital (odds ratio, 3.63; 95% confidence interval, 1.68–7.82) and lower in women who felt the antenatal care facilities were not adequate (odds ratio, 0.35; 95% confidence interval, 0.21–0.63) and who wanted longer antenatal appointments (odds ratio, 0.5; 95% confidence interval, 0.33–0.75).CONCLUSIONFew women achieved full compliance with the Nepali antenatal care standards; however, some services were delivered well. To improve, each antenatal contact needs to meet its clinical aims and be respectful. To achieve this communication and counseling training for staff, investment in health promotion and delivery of core services are needed. It is important that these interventions address key issues, such as attendance in the first trimester of pregnancy, improving privacy and optimizing communication around danger signs. However, they must be designed alongside staff and service users and their efficacy tested before widespread investment or implementation.

Phosphatidylethanol as Blood Biomarker of Alcohol Consumption in Early Pregnancy: An Observational Study in 4,067 Pregnant Women.

The teratogenic effects of alcohol are well documented, but there is a lack of screening methods to detect alcohol use during pregnancy. Phosphatidylethanol 16:0/18:1 (PEth) is a specific and sensitive biomarker reflecting alcohol intake up to several weeks after consumption. The aim of this study was to investigate the prevalence of positive PEth values as an indicator of early prenatal alcohol exposure in a general population of pregnant women. Rhesus typing is routinely performed in Norway in all pregnancies around gestational week 12. Rhesus-negative women have an additional test taken around week 24. Blood samples submitted to St. Olav University Hospital in Trøndelag, Norway, for Rhesus typing during the period September 2017 to October 2018 were collected. A total of 4,533 whole blood samples from 4,067 women were analyzed for PEth (limit of quantification of 0.003µM). Fifty-eight women had a positive PEth sample. Of these, 50 women were positive around gestational week 12, 3 women were positive around week 24, and in 5 cases, the timing was unknown. There were no significant differences in proportions of women with positive PEth values related to age, or rural versus urban residency. In an unselected pregnant population in Norway, 1.4% had a positive PEth sample around gestational week 12, whereas 0.4% had a positive sample around week 24. The use of PEth as an alcohol biomarker should be further investigated as a diagnostic tool in the antenatal setting.

975 ABO blood group, rhesus type and risk of COVID-19 in pregnant women

There is controversy regarding the association of ABO blood group, Rhesus (Rh) type and risk of COVID-19. We tested the hypothesis that ABO blood group and Rh type are associated with COVID-19 diagnosis and symptoms during pregnancy.

Modern Rhesus (Rh) typing in transfusion and pregnancy.

Patients who are Rh negative, if transfused with Rh-positive blood, can become immunized for anti-D immunoglobulin (Ig).[1][1] These patients are at risk of severe transfusion reactions, and if they become pregnant, the fetus is at risk of severe anemia. A small number (0.5%) of patients have a

Prevalence of Rhesus Negative Status Amongst Antenatal Atendees in the University of Uyo Teaching Hospital, Uyo, Nigeria: A 5-Year Review

Introduction: The Rhesus (Rh) antigen is the most polymorphic of human blood group systems second only to the ABO in transfusion and transplantation medicine with significance in iso-immunization which can cause haemolytic disease of the foetus and newborn. This study was carried out to determine the prevalence of Rhesus negativity amongst antenatal clinic attendees in the University of Uyo Teaching Hospital. Methodology: This was a 5-year retrospective study carried out between March 1st, 2012 and February 28th, 2017. Data containing the ABO and Rhesus blood group of all antenatal clinic attendees was collected from the Laboratory registers and analysed using Microsoft excel. Results: The prevalence rate of Rhesus D negative women was 4.40%. The average yearly attendance was 2861 women. The commonest blood group was O with 8232 (57.54%), followed by blood group A, 3416 (23.88%) and blood group B, 2388 (16.69%) while the least common blood group was AB, 271 (1.89%). Most Rhesus D-negative women were of blood group O; 382 (60.78%), followed by group A; 142 (22.58%), and blood group B was 94 (14.49%). AB blood group was the least; 11 (1.70%). Sensitization rate among the 629 Rhesus D-negative women was 1.11%. Conclusion: The prevalence of rhesus negativity is low in the population studied with an ABO distribution that mirrored the antenatal population, hence the overall need for immunoprophylaxis. It is however very necessary to educate and counsel all non-sensitized Rhesus negative women on the need for antenatal and post-partum immuno-prophylaxis as well as public enlightenment on the rationale for Rhesus typing, especially among women.

Frequency of alloantibody with their specification among multitransfused patients

Background and Objectives: Alloimmunization is a very common clinical problem in transfusion-dependent patients but rarely detected in Bangladesh. The risk of alloimmunization is especially high in patients who receive repeated transfusion, i.e., thalassemia patients. The objective of this study was to investigate the seroprevalence and specificity of red blood cell antibodies in multitransfused thalassemic patients. Methods: This cross-sectional study was conducted at a tertiary care referral center from January 1, 2013, to March 31, 2016. Blood specimens were sent from different facilities and also from daycare transfusion center of the same when cross-match difficulties occur. When the Coomb's test showed positive result, then Rhesus, Kell, Kid, Duffy, and Lewis blood group typing were done according to the patients' need. Serum was used to identify the presence of alloantibody by the indirect Coomb's test with known cell panels. An autocontrol, positive and negative control for each specimen was incorporated to detect autoantibody and correctness of the procedure done. We performed a simple percentage to evaluate the analysis. Results: Of 1286 cases, alloantibody was detected in 334 (25.97%) cases. Among the 334 cases, 80 (23.95%) cases were followed up by antibody identification. The remaining 254 cases were referred cases with insufficient history and were dropped from the study. The male-to-female ratio was 1:2.2. The age group of 21–30 years showed the maximum antibody specificity (7.48%). Among the 80 samples with alloantibodies, Rh antibodies were noted in 80% (64) samples. Other antibodies detected belong to Kell, Kid, Duffy, and Lewis systems. Conclusion: Multitransfused (thalassemic) patients are more vulnerable to develop alloantibody. Therefore, routine antibody screening of donors and patients and the provision of antigen negative blood is recommended.

Evaluation and Resuscitation of the Pregnant Orthopaedic Trauma Patient: Considerations for Maternal and Fetal Outcomes.

» Orthopaedic injuries warranting trauma activation in pregnant patients are associated with increased risks of preterm birth, placental abruption, and infant and maternal death.» Physiological changes associated with pregnancy can mask the severity of orthopaedic injury sustained during trauma. Providers must perform all appropriate imaging studies associated with the mechanism of injury and perform a careful clinical examination in order to avoid missing injuries.» Pregnancy is a hypercoagulable state, and adequate prophylaxis for blood clots includes low-dose heparin as well as mechanical prophylaxis. Additionally, patients who have sustained orthopaedic trauma must be assessed frequently for thrombophlebitis.» Fetal outcomes are dependent on maternal resuscitation. In addition to the normal steps of trauma resuscitation, additional measures (including Rhesus typing, obtaining a coagulation profile, placing the patient in the left lateral decubitus position, early use of supplemental oxygen to maintain SaO2 [oxygen saturation] at &gt;95%, having a low threshold for intubation, and placing a nasogastric tube to prevent aspiration) should also be performed. Fetal assessment should be completed after appropriate maternal resuscitation.» Factors related to the definitive treatment of orthopaedic injuries, including the type of surgical fixation, use of advanced imaging, and methods of surgical anesthesia, should prioritize maternal outcome. Thorough work-up of maternal injuries and comprehensive maternal resuscitation lead to the greatest benefit in terms of fetal outcomes.

Safety and pharmacodynamics of anti-CD2 monoclonal antibody treatment in cynomolgus macaques - an experimental study.

Anti-CD2 treatment provides targeted immunomodulatory properties that have demonstrated clinical usefulness to condition the immune system and to treat transplant rejection. The treatment is species-specific due to structural CD2 antigen differences between nonhuman primates and humans. Herein, we report the safety profile and efficacy of two modifications of the same anti-CD2 monoclonal antibody in cynomolgus macaques. Twelve subjects received one i.v. anti-CD2 (of rat or rhesus type) dose each, range 1-4mg/kg, and were followed for 1-7days. Treatment effects were evaluated with flow cytometry on peripheral blood and histopathological evaluation of secondary lymphoid organs. In vitro inhibitory activity on primary MHC disparate mixed lymphocyte reactions (MLRs) was determined. Upon anti-CD2 treatment, CD4+ , CD8+ memory subsets were substantially depleted. Naïve T cells and Tregs were relatively spared and exhibited lower CD2 expression than memory T cells. Early immune reconstitution was noted for naïve cells, while memory counts had not recovered after one week. Both antibodies displayed a concentration-dependent MLR inhibition. Lymph node examination revealed no significant lymphocyte depletion. None of the animals experienced any significant study drug-related adverse events. This study outlines the safety and pharmacodynamic profile of primate-specific anti-CD2 treatment, relevant for translation of anti-CD2-based animal models into clinical trials.

Estimating the Spatial Accessibility to Blood Group and Rhesus Type Point-of-Care Testing for Maternal Healthcare in Ghana.

Background: In Ghana, a blood group and rhesus type test is one of the essential recommended screening tests for women during antenatal care since blood transfusion is a key intervention for haemorrhage. We estimated the spatial accessibility to health facilities for blood group and type point-of-care (POC) testing in the Upper East Region (UER), Ghana. Methods: We assembled the attributes and spatial data of hospitals, clinics, and medical laboratories providing blood group and rhesus type POC testing in the UER. We also obtained the spatial data of all the 131 towns, and 94 health centres and community-based health planning and services (CHPS) compounds providing maternal healthcare in the region. We further obtained the topographical data of the region, and travel time estimated using an assumed tricycle speed of 20 km/h. We employed ArcGIS 10.5 to estimate the distance and travel time and locations with poor spatial access identified for priority improvement. Findings: In all, blood group and rhesus type POC testing was available in 18 health facilities comprising eight public hospitals and six health centres, one private hospital, and three medical laboratories used as referral points by neighbouring health centres and CHPS compounds without the service. Of the 94 health centres and CHPS compounds, 51.1% (48/94) and 66.4% (87/131) of the towns were within a 10 km range to a facility providing blood group and rhesus type testing service. The estimated mean distance to a health facility for blood group and rhesus POC testing was 8.9 ± 4.1 km, whilst the mean travel time was 17.8 ± 8.3 min. Builsa South district recorded the longest mean distance (25.6 ± 7.4 km), whilst Bongo district recorded the shortest (3.1 ± 1.9 km). The spatial autocorrelation results showed the health facilities providing blood group and rhesus type POC testing were randomly distributed in the region (Moran Index = 0.29; z-score = 1.37; p = 0.17). Conclusion: This study enabled the identification of district variations in spatial accessibility to blood group and rhesus type POC testing in the region for policy decisions. We urge the health authorities in Ghana to evaluate and implement recommended POC tests such as slide agglutination tests for blood group and rhesus type testing in resource-limited settings.

An enzymatic pathway in the human gut microbiome that converts A to universal O type blood.

Access to efficient enzymes that can convert A and B type red blood cells to 'universal' donor O would greatly increase the supply of blood for transfusions. Here we report the functional metagenomic screening of the human gut microbiome for enzymes that can remove the cognate A and B type sugar antigens. Among the genes encoded in our library of 19,500 expressed fosmids bearing gut bacterial DNA, we identify an enzyme pair from the obligate anaerobe Flavonifractor plautii that work in concert to efficiently convert the A antigen to the H antigen of O type blood, via a galactosamine intermediate. The X-ray structure of the N-acetylgalactosamine deacetylase reveals the active site and mechanism of the founding member of an esterase family. The galactosaminidase expands activities within the CAZy family GH36. Their ability to completely convert A to O of the same rhesus type at very low enzyme concentrations in whole blood will simplify their incorporation into blood transfusion practice, broadening blood supply.

ABO and Rhesus Types of Blood Group Distribution in Blood Donors in Blood Bank, Government Medical College and Hospital-Suryapet, Telangana: A Tertiary Care Centre Study

Aims and objectives: To study the distribution and frequencies of ABO and Rhesus (Rh) blood groups among blood donors, who participated in indoor and outdoor blood donation camps organized by suryapet blood bank, Government medical college-suryapet, Telangana. ABO and Rh typing is very important for proper functioning and safe blood banking. Materials and Methods: A Three-year retrospective study was carried out at suryapet blood bank, Telangana, during 3-year period from January 2016 to December 2018 and the total number of blood units collected was 7,035. The donors were screened and who are medically fit are accepted for blood donation. Blood group of the blood donors was determined by forward grouping and reverse grouping methods with the help of commercially available standard monoclonal antisera. Results: The most common blood group among donors was “O” (43.90%) followed by “ B” (32.50%), “A” (17.95%) and the least prevalent blood group was “AB” (05.62%). Maximum number of blood donors were Rh positive (95.72%) while Rh negative were only (04.27%). There was a higher rate of male donors than female donors. Conclusion: The present study concludes that most common blood group was “O” positive and the least common is “AB”. This data helps in appropriate maintenance of inventory in the blood bank and also plays important role in patients health care.