Investigation the Prevalence of Malaria Associated with ABO Blood Groups and Social Preventive Attitudes

ABSTRACT

The study is on “Investigation the Prevalence of Malaria Associated with ABO Blood Groups and Social Preventive Attitudes”. The study has five objectives and five research questions. This prospective and analytical study was conducted to find any correlation of malaria with blood group A, B, O and Rh. A total of 200 samples were included in this study out of which 40 (20%) samples were malaria positive and 160 (80%) samples were malaria negative. The study was conducted in Department of Microbiology, Federal Medical Centre Owerri, Imo State Nigeria. This study, found out that ABO and Rh blood groups of human beings may show differences in susceptibility to malarial infection, the total blood samples were 200 included in this study, out of which 40 samples were positive for malaria and 160 was negative. The A, B, O and Rh blood group was done using Eryscreen® of both positive as well as negative malaria cases. Maximum numbers of malaria positive cases were seen in blood group „O‟ positive followed by „A‟ „B‟ positive „A‟ and „AB‟ positive. This study suggests that the person having blood group „O‟ are more prone to malarial infection in endemic areas.

CHAPTER ONE

1.0 Introduction

Malaria is a disease of global importance that result in 300-600 million cases annually and an estimated 2.2 billion people are at risk of infection (Singh et al., 2010). Numerically the most important of the life threatening protozoan disease is malaria, which is responsible for at least 750,000 deaths a year, mostly in young children in Africa (Greenwood et al., 2012; WHO, 2015). The agent of malaria is an obligate intracellular sporozoan in the genus Plasmodium, which contains four species: P. malariae, P. vivax, P .falciparum and P. ovale(Talaro and Chess, 2012). The human and some primates are the primary vertebrate hosts for these species, which are geographically separate and show variations in the pattern and severity of disease. Over half of the world’s population is at risk from catching malaria. Malaria is currently endemic in 109 countries in four continents and of the 500 million cases of malaria estimated to occur annually, approximately one million results in death. Most of the fatalities are in children under the age of five years old and pregnant women (Lamb, 2012). Malaria accounts for at least $12 billion in economic losses each year in Africa and a reduction in annual economic growth estimated at 1.3 percent (NIH, 2010).

Blood is a body fluid in humans and other animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells. In vertebrates, it is composed of blood cells suspended in blood plasma. Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume), and contains dissipated proteins, glucose, mineral ions, hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and blood cells themselves. Albumin is the main protein in plasma, and it functions to regulate the colloidal osmotic pressure of blood (Igbenghuet al., 2012). ABO blood group system is genetically controlled and pro protein of various ABO groups differs significantly in different population and ethnic groups. Thus, any national orinternational study reporting association of ABO groups with a disease must use population frequency of ABO groups as the base for comparison (Cserti and Dzik, 2007). Almost always, an individual has the same blood group for life, but very rarely an individual’s blood type changes through addition or suppression of an antigen in infection, malignancy, or autoimmune disease. Another more common cause in blood type change is a bone marrow transplant (Pathiranaet al., 2005).

1.1 Statement of the problem

The global spread of malaria continues to be the primary health and economic concern for over one-third of the world’s population (Chen et al., 2000). Despite a clear need, no vaccine currently exists but efforts to develop are ongoing (Geels et al., 2011). Malaria is one of the leading causes of mortality and morbidity in Nigeria, accounting for 15 % of all out-patient attendance in the country‟s health facilities admissions (GOK, 2015). The most vulnerable groups are pregnant women and children under 5 years (Rijken et al., 2012). From time to time, it has been discovered that there are certain individuals who are more susceptible to P. falciparum malaria than others living in the same endemic regions (Breman, 2001). This could be accounted by several factors including developing immune response by the host, sickle cell trait, haemoglobin variants, ABO blood group and the level of G-6-P-D enzyme action (Otajevwo, 2013). The link between ABO blood groups and the incidence of P. falciparum parasitaemia is still unclear (Thakur and Verma, 1992). This is probably because the relations between the blood group and malaria have not been well studied (Singh et al. 1995). Therefore, an investigation into malaria in relation with ABO blood group has the potential of giving an insight into the pathogenesis of malaria and perhaps aid the control of this disease. The current study was designed to investigate the prevalence level of P. falciparum infections amongst individuals with different ABO blood groups in relation to their age, sex difference and parasitaemia levels.

Justification

Despite several studies, there is still lack of consensus on the association between ABO blood groups and P. falciparum infections. This might be due to limited data on the association between malaria and red blood cell ABO antigens (Nkuo-Akenji et al., 2004). Also, the data available about ABO blood groups and P. falciparum infections lacks consensus on which blood group is susceptible and which ones have protective effect on severe P. falciparum infections. Some studies suggest that individuals with blood group A are more susceptible to severe malaria whereas blood group O individuals may offer some protection against severe disease (Moulds et al., 2000 and Pathirana et al., 2005).

Other studies reported contradicting results and concluded that blood group O individuals are more susceptible to malaria attack than the other blood groups (Nkuo – Akenji et al., 2004). Studies done by Otajevwo (2013), reported equal vulnerability among the various ABO blood types. There is, therefore, no consensus yet, hence the need for more research in this area to help the understanding of malaria pathogenesis with regard to its association with ABO blood types. In addition, the above studies have focused on ABO blood grouping alone without considering the Rhesus blood group system of the subjects. This study investigated prevalence of malaria associated with ABO blood groups and social preventive attitude. Federal medical centers Owerri and Teaching hospital owerri were chosen for the study because the two health facilities are the largest in Imo State, hence receiving a large number of malaria patients especially those with complicated cases of P. falciparum malaria. Furthermore, the relatively high rainfall content received in most parts of the district (Imo State) leave the environment with stagnant water over which the mosquito larvae readily mature hence favoring malaria transmission.

Research questions

1. What is the prevalence of falciparum infections amongst individuals of different ABO and Rhesus blood groups in patients attending Federal medical centre Owerri and Teaching hospital Imo state?
2. What is the relationship between levels of falciparum parasitaemia and ABO blood groups?
3. What is the relationship between levels of parasitaemia and age of patient?
4. Does falciparum infection outcome vary between males and females?
5. What is the preventive measures use in controlling malaria?

Null hypotheses

1. Plasmodium falciparum infections are not associated with ABO blood groups among individuals of different ages and sex.
2. Plasmodium falciparum parasitaemia are not associated with ABO and Rhesus blood types among individuals of different ages and sex.
3. There is nopreventive measures in controlling malaria

1.6 Objectives of the study

1.6.1 General objective

To investigate the prevalence of malaria associated with ABO blood groups and social preventive attitudes

Specific objectives

1. To determine the prevalence level of falciparum infections among individuals with different ABO and Rhesus blood group phenotypes attending Federalmedical center and Imo State Teaching Hospital from July 2020 to March 2021.
2. To determine the relationship between levels of falciparum parasitaemia and ABO blood groups.
3. To determine the relationship between levels of parasitaemia and age of patient.
4. To determine the relationship between falciparum infections and sex.
5. To determine the social preventive measures in controlling malaria parasite

Significance of the study

The study will provide accurate information on malaria status of the patient in relation to age, sex and different ABO and Rh blood groups in the study population. The subjects will be informed whether their ABO blood groups and Rhesus factor predispose or confer resistance to P. falciparum malaria. Monthly distribution of Plasmodium falciparum infections through the study period could be used in predicting malaria trends and hence the Ministry of Health and other stakeholders can implement policies geared towards reduction of the spread of the disease. To the health practitioners and researchers, the relationship between blood group and P. falciparum infection will be given leading to better management of malaria. The results can be applied when conducting chemoprophylaxis, Intermittent Preventive Treatment (IPT) and Mass Drug Administration (MDA) as control strategies for malaria while focusing on the individuals with blood groups at highest risk of malaria. The results of the study could also be applied in strategies towards reducing malaria transmission through blood transfusion especially when transfusing blood groups with higher risk of P. falciparum infection. This is because most of the transfused blood in Nigeria is not tested for malaria (Tagny et al., 2008) despite recommendation that all donated blood should be tested for malaria where appropriate and possible (World Health Organization. http://www.who.int).

Pages:  57

Category: Project

Format:  Word & PDF         

Chapters: 1-5                                                      

Material contains Table of Content, Abstract and References.