肯尼亚不同血型个体疟疾感染负担。

Burden of malaria infection among individuals of varied blood groups in Kenya.

机构信息

Malaria Drug Resistance Laboratory, United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.

Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda.

出版信息

Malar J. 2022 Sep 1;21(1):251. doi: 10.1186/s12936-022-04251-1.

DOI:10.1186/s12936-022-04251-1

PMID:36050680

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9438094/

Abstract

BACKGROUND

The ABO blood groups consist of A, B, and H carbohydrate antigens, which regulate protein activities during malaria infection in humans. Understanding the interplay between the malaria parasite and blood group antigens is essential in understanding new interventions to reduce the global burden of malaria. This study assessed the burden of malaria infection among individuals with varying blood groups seeking treatment at selected hospitals in Kenya.

METHODS

A total of 366 samples from an ongoing malaria surveillance study were diagnosed for malaria by microscopy and further typed for blood group using ABO blood grouping. Age and sex were recorded in a data sheet, and analysed using R software version 4. Groups' proportions (blood group, malaria infection, age and sex) were compared using Pearson's Chi-square and Fischer exact tests. Wilcoxon and Kruskal-Wallis tests were performed and P-value < 0.05 was considered significant after Bonferroni correction for multiple comparisons. To understand the effect of each blood group on parasitaemia, multivariate logistic regression was used to model ABO blood group in relation to parasitaemia.

RESULTS

Of the 366 samples analysed, 312 were malaria positive, mean age was 9.83 years (< 5 years n = 152 (48.41%), 6 to 17 years n = 101 (32.16%) and > 18 years n = 61 (19.43%)). Malaria prevalence was higher among females than males, 54.46% and 45.54%, respectively. Kisumu enrolled the highest number 109 (35%)) of malaria cases, Kombewa 108 (35%), Malindi 32 (10%), Kisii 28 (9%), Marigat 23 (7%), and Kericho 12 (4%). Blood group O was the most prevalent among the enrolled individuals (46.50%), A (27.71%), B (21.02%) and AB (4.78%) respectively. Compared to blood group O+, blood group B individuals were (14%) were more likely to habour Plasmodium falciparum infection as opposed to A and AB individuals, that were 7% and 20%, respectively,. Those living in malaria-endemic zones presented with higher parasite densities compared to those living in malaria-epidemic (p = 0.0061). Individuals bearing B + blood group are more likely to habour high parasitaemia compared to O + blood group bearers (OR = 4.47, CI = 1.53-13.05, p = 0.006).

CONCLUSION

Individuals of blood group B harbour high parasitaemia compared with the blood group O, Additionally, blood group A and B present with symptoms at lower parasitaemia than blood group O. Regardles of malaria transmission zones, individuals from endemic zones showed up with high parasitaemia and among them were more individuals of blood groups A and B than individuals of blood group O. Implying that these individuals were more at risk and require additional attention and effective case management.

摘要

背景

ABO 血型由 A、B 和 H 碳水化合物抗原组成，它们在人类疟疾感染期间调节蛋白质活性。了解疟原虫与血型抗原之间的相互作用对于理解减少全球疟疾负担的新干预措施至关重要。本研究评估了在肯尼亚选定医院就诊的不同血型个体中疟疾感染的负担。

方法

对正在进行的疟疾监测研究中的 366 个样本进行了显微镜诊断，并使用 ABO 血型分组进一步进行了血型分组。在数据表中记录了年龄和性别，并使用 R 软件版本 4 进行了分析。使用 Pearson 卡方和 Fischer 精确检验比较了各组的比例（血型、疟疾感染、年龄和性别）。进行了 Wilcoxon 和 Kruskal-Wallis 检验，并且在进行多次比较的 Bonferroni 校正后，将 P 值<0.05 视为显著。为了了解每个血型对寄生虫血症的影响，使用多元逻辑回归来模拟 ABO 血型与寄生虫血症的关系。

结果

在分析的 366 个样本中，有 312 个为疟疾阳性，平均年龄为 9.83 岁（<5 岁 n=152（48.41%），6-17 岁 n=101（32.16%）和>18 岁 n=61（19.43%））。女性中疟疾的患病率高于男性，分别为 54.46%和 45.54%。基苏木（Kisumu）登记的疟疾病例最多，为 109 例（35%），科姆贝瓦（Kombewa）为 108 例（35%），马林迪（Malindi）为 32 例（10%），基西（Kisii）为 28 例（9%），马里加特（Marigat）为 23 例（7%），克里乔（Kericho）为 12 例（4%）。登记的个体中最常见的血型是 O 型（46.50%），其次是 A 型（27.71%）、B 型（21.02%）和 AB 型（4.78%）。与 O+血型相比，B 型个体（14%）更有可能感染恶性疟原虫，而 A 型和 AB 型个体分别为 7%和 20%。与生活在疟疾流行区的个体相比，生活在疟疾流行区的个体寄生虫密度更高（p=0.0061）。与 O+血型携带者相比，B+血型携带者更容易出现高寄生虫血症（OR=4.47，CI=1.53-13.05，p=0.006）。