Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USA.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Infect Dis. 2019 Jan 25;19(1):86. doi: 10.1186/s12879-019-3730-z.
Malaria clinical outcomes vary by erythrocyte characteristics, including ABO blood group, but the effect of ABO blood group on asymptomatic, uncomplicated and placental Plasmodium falciparum (P. falciparum) infection remains unclear. We explored effects of ABO blood group on asymptomatic, uncomplicated and placental falciparum infection in the published literature.
A systematic review and meta-analysis was performed using the preferred reporting items for systematic reviews and meta-analyses guidelines. Articles in Pubmed, Embase, Web of Science, CINAHL and Cochrane Library published before February 04, 2017 were searched without restriction. Studies were included if they reported P. falciparum infection incidence or prevalence, stratified by ABO blood group.
Of 1923 articles obtained from the five databases (Embase = 728, PubMed = 620, Web of Science = 549, CINAHL = 14, Cochrane Library = 12), 42 met criteria for systematic review and 37 for meta-analysis. Most studies (n = 30) were cross-sectional, seven were prospective cohort, and five were case-control studies. Meta-analysis showed similar odds of uncomplicated P. falciparum infection among individuals with blood group A (summary odds ratio [OR] 0.96, 15 studies), B (OR 0.89, 15 studies), AB (OR 0.85, 10 studies) and non-O (OR 0.95, 17 studies) as compared to those with blood group O. Meta-analysis of four cohort studies also showed similar risk of uncomplicated P. falciparum infection among individuals with blood group non-O and those with blood group O (summary relative risk [RR] 1.03). Meta-analysis of six studies showed similar odds of asymptomatic P. falciparum infection among individuals with blood group A (OR 1.05), B (OR 1.03), AB (OR 1.23), and non-O (OR 1.07) when compared to those with blood group O. However, odds of active placental P. falciparum infection was significantly lower in primiparous women with non-O blood groups (OR 0.46, 95% confidence interval [CI] 0.23 - 0.69, I 0.0%, three studies), particularly in those with blood group A (OR 0.41, 95% CI 0.003 - 0.82, I 1.4%, four studies) than those with blood group O.
This study suggests that ABO blood group may not affect susceptibility to asymptomatic and/or uncomplicated P. falciparum infection. However, blood group O primiparous women appear to be more susceptible to active placental P. falciparum infection.
疟疾临床结局因红细胞特征而有所不同，包括 ABO 血型，但 ABO 血型对无症状、无并发症和胎盘疟原虫（P. falciparum）感染的影响仍不清楚。我们在已发表的文献中探讨了 ABO 血型对无症状、无并发症和胎盘疟原虫感染的影响。
我们按照系统评价和荟萃分析的首选报告项目指南进行了系统评价和荟萃分析。检索了 2017 年 2 月 4 日之前在 Pubmed、Embase、Web of Science、CINAHL 和 Cochrane Library 发表的文章，未进行任何限制。如果文章报告了疟原虫感染发生率或患病率，并按 ABO 血型分层，则将其纳入研究。
从五个数据库（Embase=728，PubMed=620，Web of Science=549，CINAHL=14，Cochrane Library=12）中获得了 1923 篇文章，其中 42 篇符合系统评价标准，37 篇符合荟萃分析标准。大多数研究（n=30）为横断面研究，7 项为前瞻性队列研究，5 项为病例对照研究。荟萃分析显示，与 O 型血相比，A 型（汇总优势比[OR]0.96，15 项研究）、B 型（OR 0.89，15 项研究）、AB 型（OR 0.85，10 项研究）和非 O 型（OR 0.95，17 项研究）个体发生无并发症疟原虫感染的可能性相似。四项队列研究的荟萃分析也表明，非 O 型血和 O 型血个体发生无并发症疟原虫感染的风险相似（汇总相对风险[RR]1.03）。六项研究的荟萃分析显示，A 型（OR 1.05）、B 型（OR 1.03）、AB 型（OR 1.23）和非 O 型（OR 1.07）个体发生无症状疟原虫感染的可能性与 O 型血个体相似。然而，非 O 型血初产妇胎盘疟原虫感染的可能性显著降低（OR 0.46，95%置信区间[CI]0.23-0.69，I 0.0%，三项研究），尤其是 A 型血（OR 0.41，95%CI 0.003-0.82，I 1.4%，四项研究），而非 O 型血（OR 0.41，95%CI 0.003-0.82，I 1.4%）。
本研究表明，ABO 血型可能不会影响无症状和/或无并发症疟原虫感染的易感性。然而，O 型血初产妇似乎更容易发生活动性胎盘疟原虫感染。
