European Journal of Cardiovascular Medicine

At present 33 blood group systems representing over 300 antigens are listed by the International Society of Blood Transfusion. 1 The ABO system is the most important blood group system in transfusion therapy and was the first blood group system to be discovered. This great contribution to medicine was made by Landsteiner in 1900 when he observed that ‘the serum of healthy humans not only has an agglutinating effect on animal blood corpuscles, but also on human blood corpuscles from different individuals’.2

His extensive research on serology based on simple but strong scientific reasoning led to the identification of major blood groups such as O, A, and B types, compatibility testing, and subsequent practices 1 The Rhesus (Rh) system is the second most important blood group system from a transmission point of view. Identification of the Rh system is important to prevent the erythroblastosis Fetalis, which commonly arises when a Rh-negative mother carries Rh Rh-positive fetus. .3

The distribution of A B O and Rh blood groups is important for the effective management of Blood banks.4 The frequency of A B O and RhD phenotypes in different populations has been extensively studied. Different blood groups are particularly associated with different diseases as well.  In modern medicine, the need for blood group frequency and prevalence study is multipurpose, as besides its importance in evolution, its relation to disease and environment is becoming increasingly important. Blood group antigens can also be utilized in genetic research, forensic pathology, Anthropology, and in tracing the ancestral relation of human beings. 5

Ideally, a blood transfusion system should be capable of addressing 100% of clinical demand arising in healthcare facilities within its catchment area. Yet, in many developing and underdeveloped countries, there is a widespread shortfall between the demand and supply of blood due to several barriers. The major factors are increasing requirement for blood and blood products, poor implementation of voluntary donation and blood safety programs in countries, inadequate voluntary non-remunerated blood donation (VNRBD), suboptimal component separation, inadequate infrastructure, equipment and trained human resources, inappropriate use of blood and blood components, poor quality management systems, poor supply chain management systems, lack of cold chain, wastages and expiry of blood (6)               

In addition to their significance in blood transfusion practice, ABO grouping and Rh typing are also useful in clinical studies, genetic studies in population and in solving medico-legal issues. (7)

Knowledge of the distribution of pattern of different blood groups is very crucial for blood centre and blood transfusion services which are significantly contribute to the health system of the nation and to maintain donor registry.  Hence this study was conducted to determine the frequency of ABO and Rhesus (Rh) blood groups in a tertiary care Government medical college and hospital Blood Centre in western Maharashtra, India.

Aims and Objectives

To know the frequency of ABO and Rh blood group in a population of Western Maharashtra which is essential for effective management of blood inventory and to maintain blood donor registry.

·         Study setting and duration: The present study was conducted at the Government Medical College and Hospital blood centre, Miraj, located in Western Maharashtra, India.

·         Study design and sample size: It is a cross-sectional retrospective study with the sample size of 13858 healthy donors.

·         Inclusion criteria: All the voluntary non-remunerated blood donors coming to blood bank and outside the blood bank in voluntary blood donation camps were eligible as per the guidelines of Drug and cosmetics Act, 1940

·         Exclusion criteria: Donors don’t qualify as per the guidelines of Drug and cosmetics Act, 1940

Data collection:

Information regarding personal details, demographic details, occupation, and past medical history was elicited. Individuals with good health, mental alert, physical fit were selected as blood donors. The donors were then asked to sign the donor questionary as well as donor register inclusive of the inform consent.

After blood donation, A B O and Rh typing were done on each sample using the tube agglutination method according to SOPs. The Monoclonal type Antisera reagents anti-A and anti-B, and anti-D, manufactured by Tulip Diagnostics, were used. O blood group donors were tested by anti-H Lectin to rule out the Bombay blood group. Each new lot of Antisera was used after a quality control test, like Titer and avidity. Also, on each day, a daily quality control test is also performed before use of Antisera.

Reverse grouping was done using known pooled A cells, B cells and O cells from three different known donor samples. The final blood group is confirmed only if both Forward group and Reverse group are identical. All the week D groups were considered positive.

Table 1: Distribution of donors according to Gender.

Table 2: Distribution of donors according to ABO and Rh blood group system

Table 3: Comparative studies with this study

Table 4: Distribution of donors according to Rhesus Phenotype.

All human populations share the same blood group systems, although they differ in the frequency of specific types. The frequencies of ABO and Rh blood groups vary from one population to another and time to time in the same region.

Current study shows that most donors were male (96.98%) Table 1, which is consistent with other studies in most regions globally. The lower rate of donation in females (3.02%) is due to fear of donation, iron deficiency anemia and postpartum blood loss which leads to anemia in most of female donors.

In studies spanning diverse cultural and geographic groups, the most common age range for blood donation is 18 to 44 years. Our study results are consistent with this Global trend. The improved interest and ability among younger adults to donate maybe related to awareness, better Physical health and greater mobility. Older individuals may suffer from Medical conditions such as ischemic heart disease, diabetes mellitus, hypertension hence negatively impacting their ability to be well enough to donate blood.

The majority of donors in our study were voluntary, non-remunerated donors, 100%. This is consistent with other studies and global Trends. The donation of blood by voluntary, non-remunerated blood donors is critical for the safety and sustainability of the national blood supply. The national blood donation system in which replacements are typically unable to meet clinical demands for blood, while paid family members contributing a serious threat to the health and safety of the recipients. Who's recommendations are to create a health system based 100% on voluntary donation

Table 3 shows that Frequency of A B O blood groups of the present study was compared to the studies done at Lucknow by Chandra et al 12, at Punjab Sidhu et al13 at Ahmedabad by Patel PA et al14 and Wadhwa MK et al 15, at Surat by Mehta T et al 16   and at Indore by Gupta H et al. 17   In all these studies predominant blood group was `B ‘which was followed by O, A and AB

On the other hand, studies were done at Shimoga Malnad by, at Bangalore by Periyavan A et al 8 Das et al 9, Mallikarjuna et al10, Girish CJ et al11  and at Durgapur by Nag I et al 18, the commonest A B O blood group was ‘O ‘which is in contrast to present study where B is the most common A B O blood group

In other countries of the world, like in Pakistan by Anees et al19, Pramanik et al20 in Kathmandu, Nepal, Lyco et al21 in Nairobi, Kenya, showed that the blood group O was highly frequent which contrasts with our presence study.

Table 4 shows that, frequency of Rhesus blood groups of the present study was 94.92% and 5.08% for RH positive and RH negative donors, respectively. Which is like all studies except in the USA, where it is 85% and 15% respectively. Some of the factors which can affect the overall distribution of the ABO Rh blood group depend upon the donor selection and deferral which are unique to specific location.

Knowledge of the distribution of patterns of different blood groups is very crucial for blood centers and blood transfusion services, which significantly contribute to the health system of the nation. Blood group distribution is important for clinical studies, geographical information, and forensic studies in the general population. It also helps to maintain the donor registry, as there are very few voluntary donors in society, of which very few are regular donors. By preparing or making a Registry of these regular Donors as per A, B, and O Blood group differentiations, this Registry will be valuable or of great help during a blood crisis. That is why it is important to maintain the distribution of A, B, O, and Rh Blood groups

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