People donate blood during self-care celebrations in Kayunga District on July 26. The increasing research findings on the impact of blood group or type on one’s health and disease progression are improving precision inpatient treatment and disease prevention. Photo | Tonny Abet
The increasing research findings on the impact of blood group or type on one’s health and disease progression are improving precision in patient treatment and disease prevention.
Scientists in Uganda say although associations between some diseases and blood types have been documented, it is inaccurate to assume that some blood types are stronger than others.
Strong, weak blood?
“Some people who carry a protein on their blood cell surface are at lower risk of some diseases, and those whose red blood cells don’t carry that protein are at a higher risk of certain diseases. The association results from the presence of these proteins and their role in disease,” Dr Aggrey Dhabangi, a transfusion medicine physician at Makerere University College of Health Sciences, says.
Dr Dhabangi says this association is often blown out of proportion.
“The relationship between blood groups and diseases is exaggerated. Truthfully, there is nothing like a strong blood group or a weak blood group because there are many other factors that influence the disease risk,” he reasons.
Indeed, Mr Samuel Davis Wante, the clinical team leader at Uganda Blood Transfusion Service (UBTS), says all blood groups have their unique benefits and are all-important to the person and patients in need of transfusion. To him, good blood is all about the health status of the person.
“Every blood group and type is important. Blood group and type can only be of importance and purpose to both the donor and the recipient when you maintain your health quite well,” he says.
Blood type/group
Dr Dhabangi says there are 45 blood group systems recognised by the International Society of Blood Transfusion. He says the most used blood group systems in medical science (hospitals) are the ABO and Rhesus (Rh).
Dr Dhabangi says medical personnel can see where one falls through blood typing. Genes inherited from parents determine the blood types.
“We use protein or sugars on the surface of the red blood cells to tell that you have a particular blood type. They (protein and sugars on the cell surface) are the ones we use to say this cell has this, this one doesn’t have this,” he explains.
Dr Dhabangi adds: “Because the protein and sugars do different things at the surface of the cell, it may put one person at risk of disease more than the other.”
Under the ABO blood group system, there are four main blood groups or types – A, B, AB and O. For the Rh system, scientists assess the presence of the protein known as RhD on the red blood cells. If the protein is present, your blood group is RhD positive and if it’s absent, your blood group is RhD negative.
Both ABO and Rh systems are essential in blood transfusion sciences to determine if the blood of the donor is compatible with that of the recipient.
By using the two blood grouping systems, people fall in one of the eight groups. This can include A RhD positive (A+), A RhD negative (A-), B RhD positive (B+), B RhD negative (B-), O RhD positive (O+), O RhD negative (O-), AB RhD positive (AB+) and AB RhD negative (AB-).
Matching blood donors
Mr Wante says O RhD negative blood (O-) can safely be given to anyone. People with this blood type are considered universal donors and their blood is often used in medical emergencies when the blood type is not immediately known.
Mr Wante says this is done because O- blood does not have any A, B or RhD antigens on the surface of the cells and is compatible with every other ABO and RhD blood types.
However, the uniqueness of O- blood type does not apply to all blood types. Receiving blood from the wrong ABO group can be life-threatening because of a condition termed blood transfusion reaction. Scientists say this reaction, termed acute transfusion reactions, can occur during a transfusion or days to weeks later.
Risks of reactions
The available scientific information indicates that the most common signs and symptoms of transfusion reactions include fever, chills, skin rash, and itching.
“Some symptoms may resolve with little or no treatment. However, respiratory distress, high fever, hypotension (low blood pressure indicating heart and brain are not receiving enough blood), and haemoglobinuria (where a high number of red blood cells are destroyed and components excreted in urine) may indicate a more serious reaction,” reads a 2023 research report by Jolee Suddock of the University of New Mexico.
Mr Wante says the blood of the donor is always matched with that of the recipient before the transfusion to ensure the patient gets the right blood. He also says an unborn baby may be affected if the father and mother have different blood types.
Pints of blood at the Uganda Blood Transfusion Services in Nakasero, Kampala, in 2009. Residents from Karamoja sub-region have asked the Health ministry to consider setting up a blood bank in the area. PHOTO/FILE
He says a baby of a Rhesus-negative woman can experience Rhesus disease when the biological father is Rhesus-positive. The disease affects the baby, manifesting as anaemia, low muscle tone and lack of energy (weak baby). However, Anti-D immunoglobulin injection, accessed in hospitals, can prevent the disease.
Mr Wante says UBTS also ensures people don’t get infections through transfused blood.
“We are mandated to ensure that we screen this blood thoroughly to ensure it’s free from any infection before somebody receives it,” he notes.
Healthy and enough blood
Dr Dhabangi says, to have healthy and enough blood in the body, one should eat a balanced diet. He says foods with enough iron content are important in ensuring the person has sufficient nutrients required for blood formation.
“Eating a balanced diet that is rich in iron is paramount in both the young and the old. Iron is not only essential for blood formation but also for other things like cognition,” he says.
“When we talk of feeding well, you must be consuming plenty of greens, plenty of fruits, and plenty of grainy foods. Grainy foods are peanuts, beans, simsim, millet bread, posho, and rice,” Mr Wante advises.
“These are foods that help in building iron content in our body and promoting healthy blood and quality of blood in our bodies. So we encourage people to exercise, to live a healthy lifestyle, to feed well, and to socially live responsibly to avoid sexually transmitted infections like HIV,” he adds.
Blood types and risks
Dr Dhabangi, citing available scientific information, says some blood groups are more at risk of getting malaria infections than others.
“There is a blood group system called the Duffy (FY), and in that system, there are mainly three proteins but two proteins – Fya and Fyb – are more pronounced. It so happens that Africans don’t have these Duffy proteins on the surface of their red blood cells, but Caucasians have them,” he explains.
“So, the fact that most Africans lack that protein, puts them at an advantage because if you carry that Duffy protein, a species of malaria parasite called Plasmodium (P) vivax will enter the red blood cell through it (the Duffy protein).
“Scientists think that it’s because of the lack of that protein that Africans occupied and thrived in this environment. If somebody gets vivax infection, it may mean they have the Duffy protein,” he adds.
A 2017 research report by Victor Asua of the Infectious Diseases Research Collaboration, Uganda, shows that vivax infections in Uganda are limited, contributing only 0.5 percent of malaria infections.
In 2022, the World Health Organisation (WHO) reported there were an estimated 12.7 million malaria cases and more than 17,556 estimated deaths in the country.
Dr Dhabangi says they have also found that some people with certain blood groups are at higher risk of severe malaria.
“We have done research here and found that children with blood group A and B are at slightly higher risk of getting complicated malaria like cerebral malaria, compared to those with blood group O,” he says.
The medical expert says this is because there are some sugars on the surface of the red blood cells of people with blood types A and B, but people with blood group O don’t have them.
“These sugars may be one of the things that malaria uses [to cause the complication]. Cerebral malaria happens when red blood cells enter the blood pathways in the brain and get stuck and sticky on the surface of the blood pathways,” he explains.
“Somebody with blood group O may not have the sugar that causes the stickiness. But there are other chemicals that may cause stickiness of blood and this may also be found on the surface of red blood cells for people with blood group O. So, someone with blood group O may still experience severe malaria,” he adds.
Blood type and associated diseases
A report published in BioMed Research International, a scientific journal in 2021 by Ethiopian researcher Silamlak Birhanu Abegaz, highlights some of the links between blood type and disease risk but it has limited explanation for the associations.
The report titled, ‘Human ABO Blood Groups and their Associations with Different Diseases’, based on an analysis of available findings from different researchers, indicates that blood group AB individuals were found to be susceptible to an increased risk of cognitive impairment, which was independent of geographic region, age, race, and gender.
“Early etiological studies indicated that blood type O has a connection with increased incidence of cholera, plague, tuberculosis infections, and mumps, whereas blood type A is linked with increased incidence of smallpox and Pseudomonas aeruginosa infection (which affect stomach, blood and lungs),” the report reads.
The report also indicates that there is a higher incidence of cancers in the stomach, ovaries, salivary glands, cervix, uterus, and colon/rectum was common in blood type A people than in O type people.
Risks of air pollution
A 2024 study report by Tomasz Bochenek of the First Department of Cardiology, Medical University of Silesia, Poland, found that people with blood group O could get more health effects from air pollution.
The report indicates that “prolonged exposure to (air pollutants) PM2.5 and PM10 was associated with higher risk of acute coronary syndrome (ACS) –acute heart disease, in patients with blood group O” compared to those with blood groups A, B and AB. The study was published in Nature, a scientific journal.
Another 2024 report of a study by an Italian researcher published in the Journal of Cancer, indicates: “RhD-negative patients exhibited a lower age at diagnosis and had a higher overall survival compared to RhD-positive patients.”
about blood
The two most important blood group systems are ABO and Rhesus (Rh). Rhesus factor is an inherited protein that can be found on the surface of the red blood cell. If your blood type is positive, then your blood cells have the Rh protein and if it is negative, you don’t have the protein. Both blood group and blood type determine the type of blood given to a patient.
Foods for healthy, enough blood
- Plenty of greens
- Plenty of fruits
- Plenty of grainy foods like peanuts, beans, simsim, millet bread, posho, and rice
