Abstract:
Background: Genetic diversity of ABO blood, glucose-6-phosphate dehydrogenase (G6PD) deficiency and haemoglobin
type and their ability to protect against malaria vary geographically, ethnically and racially. No study has been carried out
in populations resident in malaria regions in western Kenya.
Method: A total of 574 malaria cases (severe malaria anaemia, SMA = 137 and non-SMA = 437) seeking treatment at
Vihiga County and Referral Hospital in western Kenya, were enrolled and screened for ABO blood group, G6PD deficiency
and haemoglobin genotyped in a hospital-based cross-sectional study.
Result: When compared to blood group O, blood groups A, AB and B were not associated with SMA (P = 0.380, P = 0.183
and P = 0.464, respectively). Further regression analysis revealed that the carriage of the intermediate status of G6PD was
associated with risk to SMA (OR = 1.52, 95%CI = 1.029–2.266, P = 0.035). There was, however, no association between AS
and SS with severe malaria anaemia. Co-occurrence of both haemoglobin type and G6PD i.e. the AA/intermediate was
associated with risk to SMA (OR = 1.536, 95%CI = 1.007–2.343, P = 0.046) while the carriage of the AS/normal G6PD was
associated with protection against SMA (OR = 0.337, 95%CI = 0.156–0.915, P = 0.031).
Conclusion: Results demonstrate that blood group genotypes do not have influence on malaria disease outcome in this
region. Children in Vihiga with blood group O have some protection against malaria. However, the intermediate status of
G6PD is associated with risk of SMA. Further, co-inheritance of sickle cell and G6PD status are important predictors of
malaria disease outcome. This implies combinatorial gene function in influencing disease outcome.
