Plasmodium Falciparum Infections among Individuals with Different Abo and Rhesus Blood Groups Attending Kipkelion and Fort-Ternan Hospitals in Kericho County, Kenya
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Date
2015-10
Authors
Sigei, Jonah
Journal Title
Journal ISSN
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Publisher
Kenyatta University
Abstract
Malaria is an infectious disease of humans and other animals caused by protozoa of the genus Plasmodium and is transmitted mainly through bites of infected female Anopheles mosquitoes. The main species causing the disease in humans include Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, Plasmodium vivax and Plasmodium knowlesi. The disease results from multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever, headache, vomiting and in severe cases progressing to coma and /or death. Several studies undertaken have been unable to link ABO blood groups to the incidence or to the repeat attacks of malaria. The main objective of the study was to determine the prevalence of Plasmodium falciparum infections amongst individuals with different ABO and Rhesus (Rh) blood groups. The study design was simple cross - sectional study, while population sampling technique was probability proportion to size. Three hundred and six malaria symptomatic patients who visited Kipkelion and Fort-ternan sub-District Hospitals and gave consent to take part in the study were enrolled. The clinical signs and symptoms commonly presented were fever, headache, diarrhea and joint pain. Thick blood films were used to quantify malaria parasites whereas thin blood films were used for Plasmodium species identification. The remaining portion of blood was used for phenotypic determination of blood groups. ABO blood groups were determined using commercial antisera –A and B whereas rhesus blood typing was done using antisera-D. The data obtained was statistically analyzed using SPSS version 21.0. Prevalence of P. falciparum infections amongst individuals of different ABO and Rh blood groups was statistically analyzed using Chi-square (χ2) while the relationship between parasitaemia and age was analyzed using regression analysis. Statistical significance was set at p<0.05. Frequencies and percentages of the variables were calculated and presented in form of tables, charts and graphs. Microscopic examinations of blood slides showed that 169 (55.2 %) patients were malaria positive and 137 (44.8 %) were negative. Rapid Diagonistic Tests were used to overrule possibility of low parasitaemia levels in individuals whose blood smears were negative. The results revealed that P. falciparum infection had significant and positive association with blood types A+ (χ2=10.38, df=1, p=0.001), B+ (χ2=2.68, df=1, p=0.049) and AB+ (χ2=1.98, df=1, p=0.003) with the highest proportion observed among individuals with blood group A+ 55 (32.5 %) followed by those with blood group B+ 38 (22.5 %) then O+ 34 (20.1%) while O- individuals had no infections by microscopy. Age group 0-9 years recorded the highest percentage of P. falciparum infections (36.7 %) while 40-49 years had the least percentage (4.7 %) of infected individuals. It was concluded that individuals with blood groups A+, B+ and AB+ are more susceptible to P. falciparum infections than individuals with blood groups A-, B-, O- and O+. The study recommends that such individuals should take prophylactic drugs against malaria during on-set of short and long rains and when travelling to malaria endemic regions. 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 A+, B+ and AB+.
Description
A Thesis Submitted in Partial Fulfillment of the Requirements for the Award of the Degree of Master of Science (Applied Parasitology) in the School of Pure and Applied Sciences of Kenyatta University, October 2015