Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Erythrocyte-associated antigenic polymorphisms or their absence have perhaps evolved in the human population to protect against malarial infection. Studies in various populations consistently demonstrate that blood group 'O'...

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Main Authors: Tripathy Rina, Sahu Aditya N, Panda Santosh K, Panda Aditya K, Ravindran Balachandran, Das Bidyut K
Format: Article
Language:English
Published: BMC 2011-10-01
Series:Malaria Journal
Subjects:
Online Access:http://www.malariajournal.com/content/10/1/309
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author Tripathy Rina
Sahu Aditya N
Panda Santosh K
Panda Aditya K
Ravindran Balachandran
Das Bidyut K
author_facet Tripathy Rina
Sahu Aditya N
Panda Santosh K
Panda Aditya K
Ravindran Balachandran
Das Bidyut K
author_sort Tripathy Rina
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Erythrocyte-associated antigenic polymorphisms or their absence have perhaps evolved in the human population to protect against malarial infection. Studies in various populations consistently demonstrate that blood group 'O' confers resistance against severe falciparum infection. In India, Odisha state has one of the highest incidences of <it>Plasmodium falciparum </it>infection and contributes to the highest number of deaths by falciparum malaria. This study aims to evaluate the relationship between ABO blood group and severe malaria in an adult population at the tertiary care centre in Odisha.</p> <p>Methods</p> <p>A total of 353 <it>P. falciparum </it>infected subjects and 174 healthy controls were screened for ABO blood group. Falciparum-infected individuals were categorized as severe malaria and uncomplicated malaria. Severe malaria was further clinically phenotyped into cerebral malaria, non-cerebral severe malaria and multi-organ dysfunction. A meta-analysis was performed to assess the role of ABO blood group in severe malaria.</p> <p>Results</p> <p>Frequency of blood group 'B' was significantly higher in patients with severe malaria compared to the uncomplicated cases (P < 0.0001; OR = 4.09) and healthy controls (P < 0.0001; OR = 2.79). Irrespective of the level of clinical severity, blood group 'B' was significantly associated with cerebral malaria (P < 0.0001; OR = 5.95), multi-organ dysfunction (P < 0.0001; OR = 4.81) and non-cerebral severe malaria patients (P = 0.001; OR = 3.02) compared to the uncomplicated category. Prevalence of 'O' group in uncomplicated malaria (P < 0.0001; OR = 2.81) and healthy controls (P = 0.0003; OR = 2.16) was significantly high compared to severe malaria. Meta-analysis of previous studies, including the current one, highlighted the protective nature of blood group 'O' to severe malaria (P = 0.01). On the other hand, carriers of blood group 'A' (P = 0.04) and 'AB' (P = 0.04) were susceptible to malaria severity.</p> <p>Conclusions</p> <p>Results of the current study indicate that blood group 'O' is associated with reduced and 'B' blood group with increased risk of development of severe malaria in Odisha, India. Meta-analysis also supports the protective nature of blood group 'O' from severe falciparum infection.</p>
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spelling doaj.art-80f82203b9724f38b34886177b84926b2022-12-22T01:44:20ZengBMCMalaria Journal1475-28752011-10-0110130910.1186/1475-2875-10-309Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysisTripathy RinaSahu Aditya NPanda Santosh KPanda Aditya KRavindran BalachandranDas Bidyut K<p>Abstract</p> <p>Background</p> <p>Erythrocyte-associated antigenic polymorphisms or their absence have perhaps evolved in the human population to protect against malarial infection. Studies in various populations consistently demonstrate that blood group 'O' confers resistance against severe falciparum infection. In India, Odisha state has one of the highest incidences of <it>Plasmodium falciparum </it>infection and contributes to the highest number of deaths by falciparum malaria. This study aims to evaluate the relationship between ABO blood group and severe malaria in an adult population at the tertiary care centre in Odisha.</p> <p>Methods</p> <p>A total of 353 <it>P. falciparum </it>infected subjects and 174 healthy controls were screened for ABO blood group. Falciparum-infected individuals were categorized as severe malaria and uncomplicated malaria. Severe malaria was further clinically phenotyped into cerebral malaria, non-cerebral severe malaria and multi-organ dysfunction. A meta-analysis was performed to assess the role of ABO blood group in severe malaria.</p> <p>Results</p> <p>Frequency of blood group 'B' was significantly higher in patients with severe malaria compared to the uncomplicated cases (P < 0.0001; OR = 4.09) and healthy controls (P < 0.0001; OR = 2.79). Irrespective of the level of clinical severity, blood group 'B' was significantly associated with cerebral malaria (P < 0.0001; OR = 5.95), multi-organ dysfunction (P < 0.0001; OR = 4.81) and non-cerebral severe malaria patients (P = 0.001; OR = 3.02) compared to the uncomplicated category. Prevalence of 'O' group in uncomplicated malaria (P < 0.0001; OR = 2.81) and healthy controls (P = 0.0003; OR = 2.16) was significantly high compared to severe malaria. Meta-analysis of previous studies, including the current one, highlighted the protective nature of blood group 'O' to severe malaria (P = 0.01). On the other hand, carriers of blood group 'A' (P = 0.04) and 'AB' (P = 0.04) were susceptible to malaria severity.</p> <p>Conclusions</p> <p>Results of the current study indicate that blood group 'O' is associated with reduced and 'B' blood group with increased risk of development of severe malaria in Odisha, India. Meta-analysis also supports the protective nature of blood group 'O' from severe falciparum infection.</p>http://www.malariajournal.com/content/10/1/309ABO blood groupsevere malariacerebral malariamulti-organ dysfunctionnon-cerebral severe malariauncomplicated malariameta-analysis
spellingShingle Tripathy Rina
Sahu Aditya N
Panda Santosh K
Panda Aditya K
Ravindran Balachandran
Das Bidyut K
Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis
Malaria Journal
ABO blood group
severe malaria
cerebral malaria
multi-organ dysfunction
non-cerebral severe malaria
uncomplicated malaria
meta-analysis
title Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis
title_full Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis
title_fullStr Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis
title_full_unstemmed Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis
title_short Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis
title_sort association of abo blood group with severe falciparum malaria in adults case control study and meta analysis
topic ABO blood group
severe malaria
cerebral malaria
multi-organ dysfunction
non-cerebral severe malaria
uncomplicated malaria
meta-analysis
url http://www.malariajournal.com/content/10/1/309
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