Impact of ABO Blood Groups on Malaria Susceptibility and Severity: A Systematic Review

Abstract

Malaria is a global health risk with unpredictable clinical manifestations based on host genetic factors, including ABO blood groups. This systematic review reviews the association between ABO blood types and susceptibility, severity, and haematological complications of malaria. Systematic analysis of 10 studies between the years 2009 and 2025 was conducted using data from PubMed, Scopus, CDC publications, and Malaria Journal. The criterion for inclusion was studies that assessed the relationship between malaria outcomes and ABO blood group types. Unsystematic studies and unrelated studies were not included.

The findings indicate that there is a recurring pattern of association between ABO blood groups and malaria severity. Group O blood was most frequently correlated with less severity of disease, while groups A and B were found to be riskier for severe complications including anaemia, hyperbilirubinemia, and increased parasitaemia. Several studies by Animagi et al. and Haftu Asmerom noted significantly higher odds of severe cases among group A individuals. experimental studies have provided a biological explanation, suggesting that individuals with blood group O exhibit reduced rosetting and lower erythrocyte invasion rates, which may contribute to their relative protection, These findings are relevant to clinical and public health. Identification of high-risk blood group can improve risk stratification, guide early treatment, and inform malaria control policy in endemic areas. Blood group data incorporation into diagnostic protocols and malaria management could also improve outcomes, especially in resource-constrained settings. ABO blood groups significantly influence the susceptibility and severity of malaria. Group O corresponds to relative protection, while group A and group B correspond to augmented disease burden. The addition of blood group screening to the protocols of care for malaria would improve patient outcome and direct further research on host-pathogen interaction.