Original Research Article DOI: 10.18231/2394-2126.2017.0088 Indian Journal of Clinical Anatomy and Physiology, July-September, 2017;4(3):348-352 348 Association between plasmodium falciparum malaria infection and ABO blood group system and in north Gujarat, India Manish Lamoria 1 , Alkesh Vara 2,* , Soumi H Chaudhuri 3 1,3 Assistant Professor, 3 Dept. of Anaesthesia, American International Institute of Medical Sciences, Udaipur, Rajasthan, 2 Assistant Professor, 1,2 Dept. Physiology, MP Shah Medical College, Jamnagar, Gujarat *Corresponding Author: Email: dralkeshvara1985@gmail.com Abstract Introduction: Malaria is a troublesome protozoan disease to control in tropical and subtropical countries because of menace of mosquito vector and humans easily susceptible to its bite. It is estimated to infect 200 million people and 1-3 million deaths a year according to the WHO. Among them the virulence of Plasmodium falciparum malaria is the most by the virtue of rosetting. Rosetting means adherence between infected and uninfected RBCs, which together can hinder peripheral and terminal microvasculature circulation, thus, leading to most of the dreaded complications of this disease. Objectives: To study the distribution of blood groups in patients infected with Plasmodium falciparum malaria and to evaluate the complications and deaths associated with it in admitted patients of GMERS Medical College and Hospital, Patan, Gujarat. This study also includes corroborating the hypothesis whether O blood group confers any protection against dire complications of plasmodium falciparum infection as widely believed. Materials and Method: The study was conducted from February 2012 to February-2015 (3years) on 162 confirmed patients of falciparum malaria who were admitted in GMERS Medical College, Patan and were diagnosed by thin and thick peripheral blood smear examination. Patients of all age groups were included. Control group included 1660 healthy volunteers donating blood in blood bank of the hospital. Blood grouping was done by conventional agglutination test using Monoclonal Antisera A and B on porcelain tile. The following Investigations were also collected; serum hemoglobin, platelet count, serum bilirubin, serum creatinine, random blood sugar. Complications like coma, convulsion, hypoglycemia, anemia, thrombocytopenia, hepatic dysfunction, renal dysfunction, hypotension, shock, respiratory distress and cause of death if any occurred were duly noted. Results: Out of 162 diseased patients studied in 3 years duration, percentage of patients of each blood group were A:33.80%, B:30.64%, O:24.20%, AB:11.29% respectively with blood group A has highest relative risk of 1.38 of contracting the disease among all four groups. Total 15 of 162 patients died with 6 patients each belonging to group A and B and 3 patients of group AB. Conclusion: As per this study and statistics prevalence of plasmodium falciparum malaria was found to be more among blood group A and B, along with its complications. Although blood group O patients were also not found to be immune to the infection, the presence of complications and death were indeed next to nought in them. Keywords: Malaria, Plasmodium falciparum, ABO blood group, Red blood cell, O Blood group, Rosetting. Received: 5 th January, 2017 Accepted: 21 st June, 2017 Introduction ABO blood groups were the first blood antigen system to be identified by Australian scientist Karl Landsteiner in 1905 (1) and yet it is the most relevant one in practicing today’s medicine. A, B, AB and O are the major groups of this system and are basically complex oligosaccharides made up by addition of N- acetylgalactosamine or galactose to H antigen (glycoprotein/ glycolipid backbone with fucose residue). The gene encoding for A and B phenotypes are located on chromosome 9p and its products are glycosyl transferases. Individual with transferases for N acetylgalactosamine are group A and those for galactose are group B. Those with none are group O and having both are group AB. They are expressed on the cell membrane of RBCs and various other sites like salivary gland, pancreas, liver, lung, testes, semen etc. Thus, loss or gain of these transferases will have effects not only on RBCs but other tissues also. (2) Many studies have been conducted and researches still done to advance our knowledge of natural selection. Herbert Spencer had once quoted “Survival of Fittest” after reading Charles Darwin’s Origin of Species in his book Principles of Biology in 1864. Gene polymorphism has a great role to play in natural selection as by its virtue there is some protection against inheritance of infectious diseases. That’s why, ABO blood groups have long been incriminated with being cofactors for diverse variety of diseases as it is directly related to gene polymorphism responsible for genes encoding the expressions of A, B and H antigens. (3) There are evidences documenting the presence of P. falciparum infection when ABO polymorphism had arisen. Via evidence based medicine it is proposed that malaria has quite been a selective force in expression of ABO blood groups in human beings as suggested by the distribution of ABO blood group in endemic regions for malaria. Hirszfeld et al (4) had first published their study in 1919 regarding frequencies of ABO blood group being different according to geography which were later emphasised by Mourant et al (5) in 1978.