Clinical data and distribution of ABO/Rh blood groups and sickle cell trait
Clinical data are presented in Table 1, where it was found that in terms of age groups, most patients included in the study were young (75.8%, n = 150/198) aged between 20 and 40 years. It was in this group where only individuals with the ARh(−) blood group and it was in this group where the majority of patients with sickle cell anaemia (75%) and with sickle cell trait (89.2%) were identified. As for gender, it was found that women constituted the majority in this study group (61.6%, n = 122/198) and they also represented the majority of patients with sickle cell anaemia (75%) and with the sickle cell trait (78.4%), in all blood groups women had 50% or more, in groups ABRh (+), ARh(+) and ORh(+), men represented less than 40% of the studied population. In assessing the degree of parasitaemia, it was noticed that most patients had low parasitaemia on hospital admission (less than 51 parasites/mm3) and among individuals with sickle cell anaemia, 93.8% had low parasitaemia, high parasitaemia was observed mostly in individuals of the ABRh(+), BRh(+) and ORh(+) group, which presented a percentage ranged between 25% and 38%. As for the clinical condition, most patients had a clinical picture considered moderate (53.5%, n = 106/198) and this picture was also verified concerning sickle cell trait, but it was found that 46.5% of ABRh patients (+) had a severe clinical picture, patients in the ARh(+), BRh(+) and ORh(−) group also had a severe clinical picture equal to or greater than 20%. Statistical analysis showed no statistical relationship between age group, gender, parasitaemia, and clinical condition with blood groups (p < 0.05). There was no relationship between age, parasitaemia, and clinical condition with sickle cell trait (p < 0.05), but there was a relationship between gender and sickle cell trait (p > 0.05).
Condition of work and ABO/Rh blood groups and sickle cell trait
In Fig. 1, it can be seen that of the 198 patients studied, regarding blood groups, 13 (6.6%) were from the ABRh(+) group, 4 (2.0%) were from the ARh(−) group, 49 (24.7%) were from the ARh(+) group, 42 (21.2%) were from the BRh(+) group, 5 (2.5%) were from the ORh(−) group and 85 (42.9%) were from the ORh(+) group. As for the sickle cell trait, we found that 145 (73.2%) were AA, 37 (18.7%) were AS and 16 (8.1%) were SS. Of the 16 (8.1%) patients with sickle cell anaemia, 2 were in the anaemia+) group, 5 in the BRh(+) group, and 9 in the ORh(+) group, no Rh(-) patients with sickle cell trait were found. One piece of information that aroused the most interest was to verify the work status of patients with sickle cell anaemia and it was found that among individuals with sickle cell trait, most were unemployed (62.5%, n = 10/16), others were self-employed (31, 25%, n = 5/16) and only 6.25% (1/16) work formally. To rule out the possibility that unemployment was due to age, it was calculated the mean age of the individuals studied in those studied blood groups and sickle cell traits and it was noted that all groups of individuals with sickle cell anaemia belonging to the ARh(+) groups, BRh(+) and ORh(+) had a mean age greater than 20 years old, which means that age was not the limiting factor, more possibly the health condition.
Condition of work and ABO/Rh blood groups and sickle cell trait
Evaluation of the erythrogram according to the ABO/Rh blood groups and sickle cell trait
In evaluating the erythrogram (Table 2), most patients were found to have normal haemoglobin values (above 10 mg/dL), however, it was found that all patients in the ARh(−) blood group had low haemoglobin, while in the other blood groups individuals with low haemoglobin represented percentages below 32%, while patients with sickle cell anaemia were the only ones in which 50% had low haemoglobin, in normal individuals and with sickle cell trait the percentages of individuals with low haemoglobin were less than 25%. In the evaluation of haematocrit, it was found that individuals with hematocrit that individuals with haematocrit results below the reference values (39–55%) giving a margin of 10% more than the reference values, were mostly from the ARh(−) blood group in 75% and BRh(+) in 50%, it was found that among individuals with sickle cell anaemia, individuals with low haematocrits represented about 62% of the population, while for normal individuals (AA) and with sickle cell trait (AS) these percentages were below 41%.
The evaluation of the mean corpuscular volume (MCV), verified that the majority (67.7%, n = 134/198) of the individuals presented normal values (between 71 and 100 fL), however, all the patients of the blood group ARh(-) showed low MCV, while in the other blood groups individuals with low haemoglobin represented percentages below 38%, patients with sickle cell anaemia were the only ones in which 50% of them had low MCV, in normal individuals and with trait sickle cell, the percentages of individuals with low MCH were less than 38%.
The assessment of mean corpuscular haemoglobin (MCH), found that most individuals (68.9%, n = 137/198) of the patients studied who had normal MCH results (24.1–32.6 pg), all (100%) individuals from the ARh(-) blood group had MCH below the reference values. In other groups, the percentage of patients with low MCH did not exceed 38%, and the MCH did not show many differences between individuals with sickle cell anaemia, or normal individuals (AA) and individuals with sickle cell trait (AS), since the percentages for all cases were between 37.8% to 27.3%.
The assessment of mean corpuscular haemoglobin concentration (MCHC), showed that regardless of blood group or sickle cell trait, most patients (above 90% in all groups) had high MCHC (above 39.6 mg/dL). Statistical analysis showed a relationship between haemoglobin values and ABO/Rh blood groups (p < 0.05), but there was no relationship between haematocrit, VCM, MCH, and MCHC values in blood groups (p > 0.05). Also, there was a relationship between haemoglobin values and sickle cell trait (p < 0.05), but there was no relationship between haematocrit, VCM, MCH, and MCHC values with sickle cell trait (p > 0.05).
Erythrogram parameters in ABO/Rh blood groups and sickle cell trait
Figure 2 shows the mean values of the erythrogram parameters (mean ± SD) by blood group and sickle cell trait, where it can be seen that individuals from the ARh(−) blood group, without sickle cell trait (AA), had lower haemoglobinin values (6.95 ± 1.7 mg/dL) than individuals with sickle cell anaemia in groups A (8.6 ± 2.2 mg/dL), B (7.4 ± 2.2 mg/dL) and O (9, 9 ± 4.4 mg/dL) all Rh(+) as previously described, ARh(−) patients showed the lowest mean erythrocyte values (21.8 ± 0.1%), MCV (23.3 ± 4.5 fL), MCH (74.0 ± 7.0 pg) except for MCHC which was increased in all patients, including patients with RA(−). For sickle cell traits, we noticed that individuals with sickle cell anaemia (AA) belonging to the ARh(+), BRh(+), and ORh(+) groups had an average erythrocyte smaller than normal (AA) and heterozygous (AS) individuals, however, for tests such as VCM, MCH, and MCHC, in most cases, individuals with sickle cell anaemia showed values close to or higher than normal (AA) and heterozygous (AS) individuals.
Erythrogram parameters in ABO/Rh blood groups and sickle cell trait
Evaluation of the leucocyte count according to the ABO/Rh blood groups and sickle cell trait
The evaluation of the leucocyte count (Table 3), showed that more than half of the patients had normal leukocyte (WBC) values (1–4.8 × 109/L), however, more than 30% of patients from all blood groups had altered (increased) WBC, except patients in the ARh(−) group, all had normal WBC values, for sickle cell trait, it was found that more in all groups (AA, AS, SS) more than 40% of individuals who had altered (increased) WBC values. The evaluation of neutrophils (NEUT) found that a little more than half of the patients had NEUT results between the reference values (1.8–7.7 × 109/L), patients of the ABRh(+) blood group, ARh(−) and Brh(+) presented alterations in neutrophils (low) ≤ 50%. Among individuals with sickle cell anaemia, patients with altered NEUT (low) represented about 50% of the population, while for normal individuals (AA) and with sickle cell trait (AS) these percentages were below 46%.
The lymphocyte evaluation (LINF) verified that the majority (70.4%, n = 140/198) of the individuals presented values above the reference values (1 to 4.8 × 109/L), however, in all blood groups studied there was an alteration (increase) in the leukocyte value in more than 60%, however, among patients in the ARh(−) group, these alterations occurred in only 25% of the patients, for the sickle cell trait, it was found that in all groups (AA, AS, SS) changes were greater than 66%. In the assessment of platelets (PTL), it was discovered that in the majority ty (64.2%, n = 131/198) of the patients studied who had PTL results below the reference values (150,000 and 450,000 mm3), in all groups the reduction was greater than 46% of platelets in all (100%) of the individuals of the different groups, it was verified for sickle cell trait, individuals with sickle cell anaemia (SS), more than 60% had normal PTL, while in the other groups, this percentage did not exceed 36%. Statistical analysis showed no relationship between WBC, NEUT, LINF, and PTL values with blood groups (p > 0.05). There was no statistically significant relationship between WBC, NEUT, and LINF values with sickle cell trait (p > 0.05), but there was a relationship between PTL and sickle cell trait (p < 0.05).
Figure 3 shows the mean values of the leucocyte count parameters (mean ± SD) by blood group and sickle cell trait. This shows that individuals from the blood group ABRh(+) with sickle cell trait (AS), ORh(-) without sickle cell trait (AA) and ORh(+) with sickle cell trait showed lower WBC values (3.28 ± 1.19 109/L, 4.05 ± 2.24 109/L and 3.76 ± 1.98 109/L, respectively). The mean NEUT in individuals with sickle cell trait (AS) in the ABRh(+) group and without sickle cell trait (AS) in the ARh(−) and ORh(−) groups were lower (1.60 ± 0.41 109/L, 8.25 ± 2.90 109/L and 5.48 ± 0.35 109/L, respectively) when compared to individuals of other blood groups. The mean number of lymphocytes in individuals with ARh(−) without trait sickle cell and ARh(+) with sickle cell anaemia were the lowest (3.33 ± 3.65 109/L and 3.78 ± 2.58 109/L) when compared to individuals from other groups. Mean PLT in individuals without trait sickle cell(AS) from the ARh(−) and ORh(−) groups were lower (69.0 ± 10.0 109/L and 81.5 ± 16.34 109/L, respectively) when compared to individuals from other groups.
Leucogram parameters in ABO/Rh blood groups and sickle cell trait
