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ABO blood group antigens may be associated with increased susceptibility to schistosomiasis: a systematic review and meta-analysis

  • R.E. Tiongco (a1), N.A. Paragas (a2), M.J. Dominguez (a1), S.L. Lasta (a2), J.K. Pandac (a2) and M.R. Pineda-Cortel (a3) (a4) (a5)...


Schistosomiasis or bilharzia is a widespread parasitic disease caused by blood flukes of the genus Schistosoma. Some factors have been investigated previously regarding their effect on the pathophysiological mechanism of human schistosomiasis, but the possible influence of the ABO blood group on the severity of Schistosoma infection has been the most promising. Hence, we performed a systematic review and meta-analysis to further investigate the association of the ABO blood group with schistosomiasis susceptibility. Selected publications were retrieved from PubMed up to 21 August 2018, for related studies written in English. Number of cases (with schistosomiasis) and controls (without schistosomiasis) were extracted across all ABO blood types. Odds ratios (OR) and 95% confidence intervals (CI) were computed, pooled and interpreted. Subgroup analysis by the species of Schistosoma infecting the population and the participants’ ethnicity was also performed. The overall analysis revealed heterogeneity in the outcomes, which warranted the identification of the cause using the Galbraith plot. Post-outlier outcomes of the pooled ORs show that individuals who are not blood type O are more susceptible (OR: 1.40; 95% CI: 1.17–1.67; PA < 0.001) to schistosomiasis than those who are blood type O (OR: 0.71; 95% CI: 0.60–0.85; PA < 0.001). Subgroup analysis yielded the same observations regardless of the species of schistosome and the ethnicity of the participants. Results of this meta-analysis suggest that individuals who are blood type B and A are more susceptible to schistosomiasis than those who are blood type O. However, more studies are needed to confirm our claims.


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Author for correspondence: R.E. Tiongco E-mail:


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Addisu, A and Tekeste, Z (2016) The association between ABO blood groups and intestinal schistosomiasis among Masero primary school children in Sanja, northwest Ethiopia. Journal of Tropical Diseases 4, doi: 10.4172/2329-891X.1000196.
Alemu, A et al. (2011) Soil transmitted helminths and Schistosoma mansoni infections among school children in Zarima town, northwest Ethiopia. BMC Infectious Diseases 11, 189.
Amano, J and Oshima, M (1999) Expression of the H type 1 blood group antigen during enterocytic differentiation of Caco-2 cells. Journal of Biological Chemistry 274, 2120921216.
Bensing, BA, Lopez, JA and Sullam, PM (2004) The Streptococcus gordonii surface proteins GspB and Hsa mediate binding to sialylated carbohydrate epitopes on the platelet membrane glycoprotein Ib. Infection and Immunity 72, 65286537.
Clegg, JA, Smithers, SR and Terry, RJ (1971) Acquisition of human antigens by Schistosoma mansoni during cultivation in vitro. Nature 232, 653654.
Colley, DG et al. (2014) Human schistosomiasis. The Lancet 383, 22532264.
Cooling, L (2015) Blood groups in infection and host susceptibility. Clinical Microbiology Reviews 28, 801870.
Dean, DA (1974) Schistosoma mansoni: adsorption of human blood group A and B antigens by schistosomula. The Journal of Parasitology 60, 260.
Degarege, A et al. (2014) The association between multiple intestinal helminth infections and blood group, anaemia and nutritional status in human populations from Dore Bafeno, southern Ethiopia. Journal of Helminthology 88, 152159.
Degarege, A, Hailemeskel, E and Erko, B (2015) Age-related factors influencing the occurrence of undernutrition in northeastern Ethiopia. BMC Public Health 15, 108.
Degarege, A et al. (2017) The relationship between helminth infections and low haemoglobin levels in Ethiopian children with blood type A. Journal of Helminthology 91, 278283.
Dentali, F et al. (2012) Non-O blood type is the commonest genetic risk factor for VTE: results from a meta-analysis of the literature. Seminars in Thrombosis and Hemostasis 38, 535548.
Deribew, K, Tekeste, Z and Petros, B (2012) The association of ABO blood group and urinary schistosomiasis in the Middle Awash Valley, Ethiopia. International Journal of Medicine and Medical Sciences 2, 232235.
DerSimonian, R and Laird, N (1986). Meta-analysis in clinical trials. Controlled Clinical Trials 7, 177188.
Franchini, M and Mannucci, PM (2014) ABO blood group and thrombotic vascular disease. Thrombosis and Haemostasis 112, 11031109.
Franchini, M et al. (2012) ABO blood group, hypercoagulability, and cardiovascular and cancer risk. Critical Reviews in Clinical Laboratory Sciences 49, 137149.
Gardas, A and Koscielak, J (1973) New form of A-, B-, and H-blood-group-active substances extracted from erythrocyte membranes. European Journal of Biochemistry 32, 178187.
Goldring, OL et al. (1976) Acquisition of human blood group antigens by Schistosoma mansoni. Clinical and Experimental Immunology 26, 181187.
Gomes Casavechia, MT et al. (2018) Systematic review and meta-analysis on Schistosoma mansoni infection prevalence, and associated risk factors in Brazil. Parasitology 145, 10001014.
Gupta, G and Surolia, A (2010) Glycosphingolipids in microdomain formation and their spatial organization. FEBS Letters 584, 16341641.
Higgins, JPT and Thompson, SG (2002) Quantifying heterogeneity in a meta-analysis. Statistics in Medicine 21, 15391558.
Higgins, JPT et al. (2003) Measuring inconsistency in meta-analyses. BMJ 327, 557560.
Igbeneghu, C and Olisekodiaka, JM (2014) Urinary schistosomiasis: association with ABO blood group and effect on some haematological parameters. International Journal of Basic and Applied Medical Sciences 4, 378382.
Igbeneghu, C et al. (2018) Distribution of ABO and rhesus blood groups, haemoglobin variants, phenylthiocarbamide taste perception and secretor status in urogenital schistosomiasis. International Journal of Basic and Applied Medical Sciences 12, 16.
Ioannidis, JPA and Trikalinos, TA (2007) The appropriateness of asymmetry tests for publication bias in meta-analyses: a large survey. CMAJ 176, 10911096.
Kassim, OO and Ejezie, GC (1982) ABO blood groups in malaria and schistosomiasis haematobium. Acta Tropica 39, 179184.
Lau, J, Ioannidis, JPA and Schmid, CH (1997) Quantitative synthesis in systematic reviews. Annals of Internal Medicine 127, 820826.
Liumbruno, GM and Franchini, M (2014) Hemostasis, cancer, and ABO blood group: the most recent evidence of association. Journal of Thrombosis and Thrombolysis 38, 160166.
Makaaru, CK et al. (1992) The human blood fluke Schistosoma mansoni synthesizes a novel type of glycosphingolipid. Journal of Biological Chemistry 267, 22512257.
Mantel, N and Haenszel, W (1959) Statistical aspects of the analysis of data from retrospective studies of disease. Journal of the National Cancer Institute 22, 719748.
Marionneau, S et al. (2002) Norwalk virus binds to histo-blood group antigens present on gastroduodenal epithelial cells of secretor individuals. Gastroenterology 122, 19671977.
Moher, D et al. (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 4, 1.
Nakayama, H et al. (2013) GSL-enriched membrane microdomains in innate immune responses. Archivum Immunologiae et Therapiae Experimentalis 61, 217228.
Nyame, K, Cummings, RD and Damian, RT (1987) Schistosoma mansoni synthesizes glycoproteins containing terminal O-linked N-acetylglucosamine residues. Journal of Biological Chemistry 262, 79907995.
Pearce, EJ and MacDonald, AS (2002) The immunobiology of schistosomiasis. Nature Reviews Immunology 2, 499511.
Pearce, EJ and Sher, A (1987) Mechanisms of immune evasion in schistosomiasis. Contributions to Microbiology and Immunology 8, 219232.
Pereira, FEL et al. (1979) A, B, O blood groups and hepatosplenic form of schistosomiasis mansoni (Symmer's fibrosis). Transactions of the Royal Society of Tropical Medicine and Hygiene 73, 238.
Pontier, SM and Schweisguth, F (2012) Glycosphingolipids in signaling and development: from liposomes to model organisms. Developmental Dynamics 241, 92106.
Sell, KW and Dean, DA (1972) Surface antigens on schistosoma. Clinical Experimental Immunology 12, 315324.
Suurmond, R, van Rhee, H and Hak, T (2017) Introduction, comparison, and validation of Meta-Essentials: a free and simple tool for meta-analysis. Research Synthesis Methods 8, 537553.
Trangle, KL et al. (1979) Distribution of blood groups and secretor status in schistosomiasis. Parasite Immunology 1, 133140.
Wells, GA et al. (2013) The Newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. The Ottawa Hospital Research Institute 3, 14.
World Health Organization (2015) Investing to overcome the global impact of neglected tropical diseases. Available at (accessed 8 September 2018).
World Health Organization (2016) Schistosomiasis: fact sheet. Available at (accessed 6 September 2018).
Yang, Y-H et al. (2014) Structural insights into SraP-mediated Staphylococcus aureus adhesion to host cells. PLoS Pathogens 10(6), e1004169.


ABO blood group antigens may be associated with increased susceptibility to schistosomiasis: a systematic review and meta-analysis

  • R.E. Tiongco (a1), N.A. Paragas (a2), M.J. Dominguez (a1), S.L. Lasta (a2), J.K. Pandac (a2) and M.R. Pineda-Cortel (a3) (a4) (a5)...


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