{"paper_id":"4b8b5ce7-46e6-41b1-bacf-b2ef5e1d17b6","body_text":"The role of ABO/RH blood groups in biochemical response among Plasmodium falciparum patients in Luanda, Angola | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The role of ABO/RH blood groups in biochemical response among Plasmodium falciparum patients in Luanda, Angola Euclides Sacomboio, Cruz S. Sebastião, Teresa Luzembo, Edson Cassinela, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9294099/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Background Malaria remains a leading cause of morbidity and mortality in Angola. Host genetic factors, particularly ABO and Rh blood groups, may influence the course of infection, but their role in biochemical responses is not fully understood. Herein, we assess the association between ABO/Rh blood groups and biochemical responses among patients with Plasmodium falciparum infection in Luanda, the capital city of Angola. Methods This was a cross-sectional study that enrolled 518 malaria patients. ABO/Rh blood groups and biochemical markers (creatinine, urea, glucose, ALT, AST, GGT, total and direct bilirubin) were measured. Results ORh + was the most prevalent blood group (44.6%), followed by ARh+ (22.2%) and BRh+ (22.0%). Significant associations emerged between ABO/Rh phenotypes and hepatic biochemical markers. Direct bilirubin elevation was significantly associated with blood group (p = 0.024), with BRh+ (64%) and ORh+ (61.5%) showing highest prevalence. Total bilirubin also demonstrated significant blood group associations (p = 0.004), with BRh+ (54.4%) and ORh+ (45%) groups exhibiting elevated levels, while ARh- showed predominantly normal values (80%). AST elevation varied significantly by blood group (p = 0.022), particularly in BRh + and ORh+ phenotypes. No significant associations were observed for creatinine, urea, glucose, ALT, or GGT. Conclusions ABO/Rh blood groups modulate hepatic biochemical responses in P. falciparum malaria, particularly bilirubin metabolism and hepatocellular injury markers. These findings suggest blood group phenotypes may influence disease pathophysiology and warrant consideration in risk stratification strategies. Biological sciences/Biochemistry Health sciences/Biomarkers Health sciences/Diseases Health sciences/Medical research ABO/Rh Blood groups Biochemical markers Malaria Plasmodium falciparum Angola Figures Figure 1 Introduction Malaria remains a public health concern in Angola, a sub-Saharan African country, where Plasmodium falciparum accounts for most cases. According to the WHO, Angola consistently ranks among the countries with the highest malaria burden globally, with an estimated 6.6 million cases and over 13,000 deaths reported annually [ 1 ]. Beyond the immediate clinical presentations of fever, anaemia, and parasitemia, P. falciparum malaria triggers biochemical derangements that reflect multi-organ involvement and predict clinical outcomes. The biochemical complications of severe falciparum malaria are diverse and interconnected. Hyperbilirubinemia, arising from intravascular hemolysis and hepatic dysfunction, is a hallmark of severe disease and correlates with mortality risk [ 2 , 3 ]. Elevated aminotransferases (AST and ALT) signal hepatocellular injury [ 4 , 5 ]. Renal dysfunction, manifesting as elevated creatinine and urea, complicates up to 40% of severe cases and significantly worsens prognosis [ 6 ]. Hypoglycemia represents another life-threatening complication [ 7 ], while GGT elevations may reflect cholestatic injury or oxidative stress [ 8 ]. Also, host genetic factors, particularly ABO and Rhesus (Rh) blood group polymorphisms, have emerged as important modulators of malaria susceptibility and severity. Blood group O confers protection against severe malaria, reducing risk by approximately 30–50% compared to non-O groups [ 9 ]. This protective effect operates primarily through reduced rosetting, wherein P. falciparum-infected erythrocytes bind to uninfected red blood cells via parasite ligands such as PfEMP1 [ 10 ]. The A and B antigens on non-O erythrocytes serve as host receptors for rosetting, facilitating larger and more stable rosette formation [ 11 ]. Rosetting promotes microvascular sequestration, impairs blood flow, and exacerbates tissue hypoxia, thereby driving severe disease manifestations [ 12 ]. Blood group A has been particularly associated with increased risk of severe malaria, with odds ratios ranging from 1.5 to 2.0 in multiple African cohorts [ 13 , 14 ]. Despite accumulating evidence that ABO blood groups influence malaria severity and that biochemical derangements predict clinical outcomes, the potential interaction between blood group phenotypes and biochemical responses to P. falciparum infection has not been explored. This study evaluated the impact of ABO and Rh blood groups in modulating biochemical responses to P. falciparum malaria in an Angolan cohort, assessing associations between blood group phenotypes and key biochemical markers, including glucose, creatinine, urea, bilirubin, AST, ALT, and GGT. Methodology Study design and setting This was a cross-sectional study conducted at the Josina Machel and Hospital Geral terciare health units, located in Luanda, the capital city of Angola, between January 2023 and December 2024. The study was conducted in accordance with the guidelines of the Declaration of Helsinki and approved by the Ethics Committee for Research Involving Human Subjects and the Scientific Council of the Institute of Health Sciences at Agostinho Neto University (Approval No. 118/GD/ICISA/UAN/2021, approved on February 25, 2021). Also, consent was obtained from both participating hospitals, Hospital Josina Machel (No. 36/DPC/HJM/2023) and Hospital Geral (No. 272/DPC/HGL/2023). Written informed consent was obtained from all participants or their legal guardians before enrollment and sample collection. From an initial pool of 1,200 patients screened, 518 met the inclusion criteria and were enrolled in the study. Patients under 12 years old, pregnant women, individuals with cerebral malaria, and those presenting comorbidities such as diabetes, hypertension, cardiovascular disease, chronic kidney disease, or HIV infection, as well as patients over 70 years of age, were excluded to minimise confounding factors. Laboratory procedure Hospital clinicians using standard clinical criteria performed malaria diagnosis. Then, the research team carried out confirmation through rapid diagnostic tests (SD-Bioline Malaria Ag Pf/PAN) and microscopic examination. Parasitemia was calculated against 200 WBCs according to WHO recommendations. Clinical severity (mild, moderate, severe) was defined following WHO criteria based on symptoms, laboratory findings, and organ involvement. Parasitemia was classified quantitatively according to parasite density per microliter of blood, such as low (≤ 50 parasites/µL), moderate (51–1,000 parasites/µL), high (1,001–10,000 parasites/µL), and very high (> 10,000 parasites/µL), following WHO guidelines [ 1 ]. Peripheral venous blood was collected into EDTA tubes for ABO and Rh blood grouping. Blood group phenotyping was performed by microplate agglutination assay using commercial anti-A, anti-B, and anti-D sera (Immucor, Portugal), following manufactors instrutions. Biochemical analyses were performed on serum samples using the Biobase BK-200 automatic biochemical analyzer (model BK-200, serial no. SHY2002220510382, China). Biochemical parameters such as creatinine, direct and total bilirubin, urea, glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were measured. Clinical significance was assigned to values deviating more than 10% from established reference ranges of creatinine (0.55–1.41 mg/dL), direct bilirubin (≤ 1.1 mg/dL), total bilirubin (0.23–1.32 mg/dL), urea (18.1–55.0 mg/dL), glucose (63.1–110.0 mg/dL), ALT (18.7–36.3 U/L), AST (7.3–41.8 U/L), and GGT (4.6–66.0 U/L). Statistical analysis Data were analysed using SPSS v.31 (IBM SPSS Statistics, USA). Descriptive statistics included means and standard deviations for normally distributed continuous variables and frequencies with percentages for categorical variables. The chi-square and univariate logistic regression were applied to assess associations between categorical variables, and significance was defined as p < 0.05. Graphical data presentations were generated using SigmaPlot version 16.0. Results Sociodemographic profile related to ABO/Rh blood group distribution. The demographic characteristics of the study population and their putative association with ABO/Rh blood groups are summarised in Table 1 . A total of 518 patients with Plasmodium falciparum malaria were included in the analysis. The ORh+ blood group was the most prevalent (44.6%, 231/518), followed by ARh+ (22.2%) and BRh+ (22.0%). Age distribution showed that the majority of participants were young (58.9%), followed by adolescents (25.5%), adults (11.2%), and elderly individuals (4.4%). Across all age groups, ORh+ remained the dominant blood group, with no statistically significant association between age and ABO/Rh distribution (p = 0.335). Gender was significantly associated with ABO/Rh blood groups (p = 0.041). Male patients accounted for 52.3% of the study population and predominated in the BRh- (66.7%), BRh+ (56.1%), ORh- (57.1%), and ORh+ (56.7%) categories, while female patients had higher proportions of ABRh+ (72.2%), ARh- (60.0%), and ARh+ (53.0%) phenotypes. Regarding place of residence, 38.2% of patients lived in urban areas, 25.9% in peri-urban areas, and 35.9% in rural areas. No significant association was observed between area of ​​residence and blood group distribution (p = 0.142). Occupational status showed that more than half of participants were students (54.2%), followed by informal workers (28.2%), formal workers (11.8%), and unemployed individuals (5.8%). A borderline significant association was observed between occupation and ABO/Rh blood groups (p = 0.050), with students and informal workers predominating in almost all blood groups. Table 1 Sociodemographic characteristics related to ABO/Rh blood group distribution among malaria patients in Angola Demographic characteristics N (%) ABO bloods groups p-value ABRh+ ARh- ARh+ BRh- BRh+ ORh- ORh+ Overall 518(100) 36(6.9) 5(1.0) 115(22.2) 3(0.6) 114(22.0) 14(2.7) 231(44.6) Age Groups Teenegers 132(25.5) 9(25.0) 1(20.0) 34(29.6) 1(33.3) 26(22.8) 3(21.4) 58(25.1) 0.335 Yougs 305(58.9) 22(61.1) 4(80.0) 63(54.8) 1(33.3) 76(66.7) 6(42.9) 133(57.6) Adults 58(11.2) 2(5.6) 0(0.0) 14(12.2) 0(0.0) 9(7.9) 4(28.6) 29(12.6) Elderly 23(4.4) 3(8.3) 0(0.0) 4(3.5) 1(33.3) 3(2.6) 1(7.1) 11(4.8) Gender Female 247(47.7) 26(72.2) 3(60.0) 61(53.0) 1(33.3) 50(43.9) 6(42.9) 100(43.3) 0.041 Male 271(52.3) 10(27.8) 2(40.0) 54(47.0) 2(66.7) 64(56.1) 8(57.1) 131(56.7) Residence Zone Urban 198(38.2) 13(36.1) 1(20.0) 42(36.5) 2(66.7) 48(42.1) 1(7.1) 91(39.4) 0.142 Peri-urban 134(25.9) 8(22.2) 1(20.0) 22(19.1) 0(0.0) 30(26.3) 5(35.7) 68(29.4) Rural 186(35.9) 15(41.7) 3(60.0) 51(44.3) 1(33.3) 36(31.6) 8(57.1) 72(31.2) Working Condition Formal Worker 61(11.8) 8(22.2) 1(20.0) 14(12.2) 1(33.3) 9(7.9) 0(0.0) 28(12.1) 0.050 Informal Worker 146(28.2) 5(13.9) 0(0.0) 33(28.7) 1(33.3) 33(28.9) 6(42.9) 68(29.4) Unemployed 30(5.8) 3(8.3) 2(40.0) 6(5.2) 0(0.0) 10(8.8) 1(7.1) 8(3.5) Student 281(54.2) 20(55.6) 2(40.0) 62(53.9) 1(33.3) 62(54.4) 7(50.0) 127(55.0) Note: Bold numbers mean that the results of the test were statistically significant ABO/RH blood groups and biochemical response . In the evaluation of the biochemical response of malaria patients according to blood type (Table 2 ), we analyzed various biochemical markers in 518 malaria patients, comparing their levels across different ABO/Rh blood groups to understand any associations. About 28% of patients had low creatinine, while 34.7% had high levels. Although the ABRh+ group had the highest percentage of low creatinine cases (41.7%), there was no statistically significant relationship between creatinine levels and blood groups (p = 0.141). A significant association was observed between direct bilirubin levels and blood groups (p = 0.024). Most patients (59.1%) had elevated direct bilirubin, especially in the BRh+ (64%) and ORh+ (61.5%) groups. Total bilirubin levels also showed a significant association with blood groups (p = 0.004). Notably, the ARh- group had the highest proportion of patients with low total bilirubin (80%), while the BRh+ (54.4%) and ORh+ (45%) blood groups tended to have higher total bilirubin levels. AST levels were significantly associated with blood groups (p = 0.022). The B Rh + and O Rh+ groups had the highest percentages of elevated AST. On the other hand, urea, glucose, ALT, and GGT levels did not vary significantly between blood groups (p < 0.05). Table 2 ABO/RH blood groups and biochemical response among malaria patients in Angola Biochemical Response N (%) ABO bloods groups p-value ABRh+ ARh- ARh+ BRh- BRh+ ORh- ORh+ Overall 518(100 36(6.9) 5(1.0) 115(22.2) 3(0.6) 114(22.0) 14(2.7) 231(44.6) Blood Creatinine Concentration (mg/dL) Low(≤ 0.54 mg/dL) 145(28.0) 15(41.7) 1(20.0) 20(17.4) 1(33.3) 35(30.7) 2(14.3) 71(30.7) 0.141 Normal(0.55–1.41 mg/dL) 193(37.3) 11(30.6) 1(20.0) 51(44.3) 2(66.7) 39(34.2) 8(57.1) 81(35.1) High(≥ 1.42 mg/dL) 180(34.7) 10(27.8) 3(60.0) 44(38.3) 0(0.0) 40(35.1) 4(28.6) 79(34.2) Blood Direct Bilirubin Concentration (mg/dL) Normal(≤ 1.1 mg/dL) 212(40.9) 14(38.9) 4(80.0) 51(44.3) 2(66.7) 41(36.0) 11(78.6) 89(38.5) 0.024 High(≥ 1.2 mg/dL) 306(59.1) 22(61.1) 1(20.0) 64(55.7) 1(33.3) 73(64.0) 3(21.4) 142(61.5) Blood Total Bilirubin (mg/dL) Low(≤ 0.22 mg/dL) 128(24.7) 6(16.7) 4(80.0) 23(20.0) 1(33.3) 25(21.9) 5(35.7) 64(27.7) 0.004 Normal(0.23–1.32 mg/dL) 159(30.7) 18(50.0) 1(20.0) 42(36.5) 1(33.3) 27(23.7) 7(50.0) 63(27.3) High(≥ 1.33 mg/dL) 231(44.6) 12(33.3) 0(0.0) 50(43.5) 1(33.3) 62(54.4) 2(14.3) 104(45.0) Blood Urea Concentration (mg/dL) Low(≤ 18.0 mg/dL) 92(17.9) 9(25.0) 0(0.0) 18(15.7) 1(50.0) 14(12.5) 2(14.3) 48(20.9) 0.639 Normal(18.1–55.0 mg/dL) 216(42.0) 13(36.1) 2(40.0) 47(40.9) 1(50.0) 53(47.3) 7(50.0) 93(40.4) High(≥ 55.1 mg/dL) 206(40.1) 14(38.9) 3(60.0) 50(43.5) 0(0.0) 45(40.2) 5(35.7) 89(38.7) Blood Glucose Concentration (mg/dL) Low(≤ 63.0 mg/dL) 75(14.5) 4(11.1) 0(0.0) 20(17.4) 0(0.0) 13(11.4) 6(42.9) 32(13.9) 0.115 Normal(63.1–110.0 mg/dL) 313(60.4) 21(58.3) 5(100.0) 69(60.0) 3(100.0) 74(64.9) 5(35.7) 136(58.9) High(≥ 110.1 mg/dL) 130(25.1) 11(30.6) 0(0.0) 26(22.6) 0(0.0) 27(23.7) 3(21.4) 63(27.3) Blood ALT Concentration (U/L) Low(≤ 18.6 U/L) 284(54.8) 17(47.2) 5(100.0) 64(55.7) 3(100.0) 62(54.4) 9(64.3) 124(53.7) 0.152 Normal(18.7–36.3 U/L) 38(7.3) 3(8.3) 0(0.0) 5(4.3) 0(0.0) 15(13.2) 0(0.0) 15(6.5) High(≥ 36.4 U/L) 196(37.8) 16(44.4) 0(0.0) 46(40.0) 0(0.0) 37(32.5) 5(35.7) 92(39.8) Blood AST Concentration (U/L) Low(≤ 7.2 U/L) 27(5.2) 3(8.3) 2(40.0) 6(5.2) 0(0.0) 6(5.3) 2(14.3) 8(3.5) 0.022 Normal(7.3–41.8 U/L) 163(31.5) 14(38.9) 2(40.0) 37(32.2) 2(66.7) 28(24.6) 3(21.4) 77(33.3) High(≥ 41.9 U/L) 328(63.3) 19(52.8) 1(20.0) 72(62.6) 1(33.3) 80(70.2) 9(64.3) 146(63.2) Blood Gama GT Concentration (U/L) Low(≤ 4.5 U/L) 11(2.1) 0(0.0) 0(0.0) 3(2.6) 0(0.0) 4(3.5) 0(0.0) 4(1.7) 0.571 Normal(4.6–66.0 U/L) 375(72.4) 21(58.3) 4(80.0) 79(68.7) 3(100.0) 86(75.4) 11(78.6) 171(74.0) High(≥ 66.1 U/L) 132(25.5) 15(41.7) 1(20.0) 33(28.7) 0(0.0) 24(21.1) 3(21.4) 56(24.2) Note: Bold numbers mean that the results of the test were statistically significant Distribution of biochemical parameter concentrations in relation to ABO/Rh blood groups. Figure 1 A presents the distribution of mean concentrations and standard deviation of creatinine, direct bilirubin, and total bilirubin among individuals with different ABO/Rh blood groups. For creatinine, the overall mean among the studied population was 4.48 ± 16.36 mg/dL, notably above the upper limit of the normal reference range (0.55–1.41 mg/dL). Stratifying by blood group, the ARh- group exhibited the highest mean creatinine level (13.13 ± 11.62 mg/dL), followed by BRh+ (5.51 ± 25.55 mg/dL), ORh+ (4.82 ± 15.90 mg/dL), and ARh+ (3.72 ± 11.6 mg/dL). Interestingly, only individuals belonging to the BRh- blood group showed a mean creatinine concentration (0.64 ± 0.47 mg/dL) within the reference range. About direct bilirubin, the overall mean was 5.62 ± 12.1 mg/dL, well above the normal threshold (≤ 1.1 mg/dL). Elevated mean values were particularly prominent in the BRh+ (6.98 ± 11.57 mg/dL), BRh- (6.82 ± 11.32 mg/dL), and ARh+ (6.82 ± 19.68 mg/dL) blood groups. The ARh- blood group presenting the lowest mean value (0.50 ± 0.53 mg/dL), and was the only group with a direct bilirubin concentration within the physiological range. As for total bilirubin, the overall mean was 3.03 ± 6.20 mg/dL. The highest values were observed in ARh+ (3.47 ± 6.80 mg/dL), BRh+ (3.37 ± 5.37 mg/dL), and ORh+ (2.97 ± 6.81 mg/dL). Conversely, ARh- (0.35 ± 0.34 mg/dL), BRh- (1.32 ± 1.88 mg/dL), and ORh- (1.34 ± 3.17 mg/dL) groups exhibited values within or near the normal reference interval (0.23–1.32 mg/dL). Figure 1 B illustrates the distribution of mean serum urea and glucose concentrations across different ABO/Rh blood groups. The overall mean urea level among the studied population was elevated at 81.80 ± 95.98 mg/dL, notably exceeding the upper limit of the reference range (18.1–55.0 mg/dL). The stratified analysis revealed that only individuals with the BRh- blood group had mean urea concentrations (37.09 ± 21.77 mg/dL) within normal reference values. All other blood groups presented elevated mean urea levels, with the A Rh- group displaying the highest mean (155.04 ± 119.05 mg/dL), followed by ARh+ (103.7 ± 128.60 mg/dL). In contrast, glucose concentrations remained largely within the physiological reference range (63.1–110 mg/dL) across most blood groups, with an overall mean of 100 ± 60.0 mg/dL. The ABRh+ group showed a slightly elevated mean glucose level (118 ± 127.8 mg/dL), marginally surpassing the upper reference limit. Based on the analysis presented in Fig. 1 C, the overall mean level of ALT/TGO was 42.8 ± 62.49 U/L, which is above the reference range (26.2–36.3 U/L). Among all blood groups, only individuals with the BRh+ phenotype had ALT values within the normal range (34.2 ± 33.2 U/L). The lowest mean ALT levels were observed in ARh- (13.64 ± 3.5 U/L) and BRh- (14.6 ± 10.5 U/L) individuals, both falling below reference limits. Conversely, elevated ALT levels were found in patients with ORh- (61.9 ± 102 U/L), ARh+ (47.7 ± 82.6 U/L), ABRh+ (44.4 ± 54.6 U/L), and ORh+ (44.1 ± 60.8 U/L) blood groups. Regarding AST/TGP, the average value among the cohort was 99.6 ± 198 U/L, well above the standard reference (7.3–41.8 U/L). Only patients with the ARh- blood group had mean AST levels within the normal range (23.2 ± 27.2 U/L). All other blood groups presented elevated AST concentrations, particularly ARh+ (117 ± 342 U/L), ABRh+ (106 ± 133 U/L), ORh+ (96.8 ± 145 U/L), and BRh+ (94.4 ± 111 U/L). In the case of GGT, the overall mean was 58.6 ± 91.1 U/L, within the laboratory reference range (4.6–66.0 U/L). Most blood groups presented mean GGT levels within normal range, except ABRh+ individuals, who showed an elevated mean (78.9 ± 149 U/L). Discussion To our knowledge, this study provides the first assessment of how ABO and Rh blood group phenotypes modulate biochemical responses to P. falciparum malaria in Angolan patients. Our results revealed significant associations between blood groups and bilirubin metabolism, as well as markers of hepatocellular injury; on the other hand, they do not show significant relationships with renal function or glucose homeostasis. These findings are important for understanding the pathophysiology of malaria as well as for the development of risk-stratification strategies based on blood groups in African populations. The distribution of blood groups in our cohort, with ORh+ being the most prevalent (44.6%), followed by Arh+ (22.2%) and BRh+ (22%), is consistent with previous reports from Angola and other sub-Saharan African populations [ 15 ]. The observed association between blood group distribution and sex (p = 0.041) among malaria patients deserves further investigation. Although ABO blood groups are inherited independently of sex chromosomes, gender-specific differences in malaria exposure, healthcare-seeking behavior, or survival could influence the observed distribution in a clinical cohort. A significant association was observed between blood groups and bilirubin levels. Direct bilirubin showed a significant association with blood group (p = 0.024), as did total bilirubin (p = 0.004). Specifically, patients with BRh + and O Rh+ blood groups had elevated bilirubin levels, while ARh- appeared to have a protective effect. This pattern is complex and does not align with the established protective effect of blood group O against severe malaria. Several mechanisms may explain these findings. First, hyperbilirubinemia in malaria arises from both intravascular hemolysis and liver dysfunction [ 2 , 3 ]. The hemolytic component, driven by parasite clearance, immune system-mediated destruction, and oxidative damage to erythrocyte membranes, generates unconjugated bilirubin. The hepatic component reflects impaired conjugation and excretion of bilirubin due to hepatocyte dysfunction, cholestasis, or microvascular obstruction in the liver [ 4 ]. Our finding that both direct and total bilirubin are associated with blood group suggests that blood group influences hemolytic and hepatic pathways, deserving further studies in this direction. Elevated bilirubin in BRh+ patients is consistent with previous observations that blood group B is associated with increased malaria severity [ 8 , 16 ]. The blood groups A and B express glycosylated antigens that serve as receptors for P. falciparum rosette ligands [ 11 ]. Increased rosette formation in group B patients may promote microvascular sequestration in the liver, leading to hepatic hypoxia, hepatocellular dysfunction, and impaired bilirubin metabolism [ 17 , 18 ]. The finding that O Rh+ patients also presented elevated bilirubin is unexpected, given the protective effect of blood group O against severe malaria. However, it is important to note that the protection of blood group O operates primarily by reducing rosette formation and severe manifestations of the disease, such as cerebral malaria and multiorgan dysfunction [ 10 , 19 ]. Indeed, some studies suggest that, at high levels of parasitemia, O blood group erythrocytes may be more susceptible to hemolysis, potentially negating the protective effect of sequestration [ 3 ]. This could explain the elevated bilirubin in Rh+ patients in our cohort. On the other hand, blood group A is generally associated with increased malaria severity [ 20 ], however, the Rh- blood group showed lower bilirubin levels in our study. The Rh factor has received less attention than ABO in malaria research, but evidence has suggested that Rh antigens may influence the efficiency of parasite invasion or the immunological recognition of infected cells [ 20 ]. Elevated AST showed a significant association with blood group (p = 0.022), indicating that blood group phenotype influences patterns of hepatocellular injury. AST is released by hepatocytes, cardiac myocytes, and erythrocytes during cellular damage, and its elevation in malaria reflects both hepatic dysfunction and hemolysis [ 21 ]. The pattern of AST elevation among blood groups likely mirrors the bilirubin findings, with groups predisposed to greater rosette formation and microvascular obstruction exhibiting more pronounced hepatocellular injury. It is worth mentioning that AST elevations in malaria are modest compared to viral hepatitis or drug-induced liver injury, reflecting the predominantly hemolytic, rather than hepatocellular, nature of jaundice associated with malaria [ 4 ]. The fact that ALT did not show significant associations with blood group (p > 0.05) corroborates this interpretation, since ALT is more specific to hepatocytes and less influenced by hemolysis [ 22 ]. The AST/ALT ratio in malaria is frequently elevated, consistent with a mixed hemolytic-hepatic picture [ 23 ]. The absence of significant associations between blood groups and creatinine, urea, glucose, ALT, and GGT requires careful interpretation. For renal function markers (creatinine and urea), several explanations are possible for the absence of associations with blood groups. Acute kidney injury in severe malaria is multifactorial, involving hypovolemia, microvascular obstruction, immune complex deposition, and direct parasite-mediated injury [ 24 ]. Although rosette formation contributes to microvascular pathology, kidney injury may be less dependent on rosette formation than cerebral or hepatic complications, potentially explaining the lack of association with blood group [ 25 ]. The absence of an association between glucose and blood group is consistent with the fact that hypoglycemia in malaria is primarily driven by increased glucose consumption by parasites and host immune cells, impaired hepatic gluconeogenesis, and the effects of medications [ 7 ]. It is unlikely that these mechanisms are strongly influenced by rosette formation or blood group-dependent cytoadherence. Similarly, the absence of associations with ALT and GGT suggests that the effects of blood group on liver function are selective, primarily affecting pathways related to hemolysis and AST release, rather than specific hepatocyte injury (ALT) or cholestatic pathways (GGT) [ 22 ]. Our findings support a model in which non-O blood groups, particularly B, promote larger and more stable rosettes, leading to increased hepatic sequestration, hepatocyte hypoxia, and increased hemolysis [ 12 , 19 ]. This manifests as elevated bilirubin and AST levels. Therefore, malaria patients with the BRh+ blood group may require more rigorous monitoring of liver function and bilirubin levels. This study has some limitations. Firstly, the cross-sectional design prevents the assessment of temporal dynamics and causal inference. Therefore, longitudinal studies that follow the biochemical changes throughout infection and treatment are needed to clarify how blood group influences disease progression in Angolan population. Secondly, our study was conducted in Luanda, which may limit generalizability to other regions of Angola or malaria-endemic areas with different parasite strains, transmission intensities, or population genetic characteristics. Thirdly, the size of our sample for some blood group and Rh factor combinations, particularly rare phenotypes such as Arh- and ABRh-, was small, reducing statistical power. Finally, genetic heterogeneity within ABO blood groups was not assessed, although recent evidence suggests genotype-specific differences in rosette formation and malaria severity [ 26 ]. Despite these limitations, our study presents important insights into the modulating role of blood groups in biochemical responses in patients with non-severe malaria, which should be further explored in future longitudinal studies with larger sample sizes and across different regions of Angola. Conclusion In conclusion, our study demonstrates that ABO and Rh blood groups significantly modulate biochemical responses to P. falciparum malaria, mainly bilirubin metabolism and markers of hepatocellular injury. B Rh + and O Rh+ blood groups are associated with elevated bilirubin levels, while A Rh- appears to have a protective effect. Declarations Ethics approval and consent to participate The study was conducted in accordance with the guidelines of the Declaration of Helsinki and approved by the Ethics Committee for Research Involving Human Subjects and the Scientific Council of the Institute of Health Sciences at Agostinho Neto University (Approval No. 118/GD/ICISA/UAN/2021, approved on February 25, 2021), Hospital Josina Machel (No. 36/DPC/HJM/2023) and Hospital Geral (No. 272/DPC/HGL/2023). Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Funding This project was funded by the European Union and the African Union through the 2022 ARISE-PP-13 Project, which is coordinated by the African Academy of Sciences. Moreover, the project was co-financed by the Science and Technology Development Project (PDCT) of the Ministry of Higher Education, Science, Technology and Innovation of Angola through financial support for research and the design of a Post-doctoral scholarship for the principal investigator. Author Contribution Conceptualisation: ES and FA. Data curation: ES, CSS, and FA. Formal analysis: ES, CSS, and FA. Funding acquisition: ES and FA. Methodology: ES, TL, and FA Investigation: ES, CSS, TL, EC, EE-V, JM, and FA. Project administration: ES and FA. Supervision: ES and FA. Validation: ES. Writing – original draft: ES and CSS. Writing – review & editing: ES, CSS, and FA. All authors have seen and approved the submitted version of this manuscript. Acknowledgement The authors would like to thank all participants who generously contributed their time to this study. We are also grateful to the management of Prenda Hospital for logistical support as well as the CKS Speed Science for scientific support. Data Availability The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. References World Health Organisation (WHO). World Malaria Report 2023 (World Health Organization, 2023). Das, A., Khan, A. & Sarma, G. Profile of acute severe malaria with hepatopathy. Int. J. Med. Public. Health . 4 , 371 (2014). Chandra, S., Dhawale, S. & Chouhan, A. HEPATIC DYSFUNCTION IN FALCIPARUM MALARIA. J. Evol. Med. Dent. Sci. 4 , 184–191 (2015). Chughlay, M. F. et al. Liver Enzyme Elevations in Plasmodium falciparum Volunteer Infection Studies: Findings and Recommendations. Am. J. Trop. Med. Hyg. 103 , 378–393 (2020). Enwere, G. C. et al. Biochemical and haematological variables in Gambian children with cerebral malaria. Ann. Trop. Paediatr. 19 , 327–332 (1999). Koopmans, L. C. et al. Acute kidney injury in imported Plasmodium falciparum malaria. Malar. J. 14 , 523 (2015). Ahmad, S., HOSPITAL-BASED RETROSPECTIVE COMPARATIVE STUDY OF COMPLICATIONS, O. U. T. C. O. M. E. S. & CLINICAL AND LABORATORY PARAMETERS OF MALARIA WITH AND WITHOUT NEUROLOGICAL INVOLVEMENT. A. Mediterr. J. Hematol. Infect. Dis. 9, e2017006 (2016). Panda, A. K. et al. Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis. Malar. J. 10 , 309 (2011). Degarege, A., Gebrezgi, M. T., Ibanez, G., Wahlgren, M. & Madhivanan, P. Effect of the ABO blood group on susceptibility to severe malaria: A systematic review and meta-analysis. Blood Rev. 33 , 53–62 (2019). Opi, D. H. et al. Non-O ABO blood group genotypes differ in their associations with Plasmodium falciparum rosetting and severe malaria. PLoS Genet. 19 , e1010910 (2023). Rowe, J. A. et al. Blood group O protects against severe Plasmodium falciparum malaria through the mechanism of reduced rosetting. Proceedings of the National Academy of Sciences 104, 17471–17476 (2007). Afoakwah, R., Aubyn, E., Prah, J., Nwaefuna, E. K. & Boampong, J. N. Relative Susceptibilities of ABO Blood Groups to Plasmodium falciparum Malaria in Ghana. Adv. Hematol. 1–4 (2016). (2016). Tadesse, H. & Tadesse, K. Assessing the association of severe malaria infection and ABO blood groups in northwestern Ethiopia. J. Vector Borne Dis. 50 , 292–296 (2013). Panda, A. K. et al. Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis. Malar. J. 10 , 309 (2011). Sacomboio, E. N. M. et al. Blood count changes in malaria patients according to blood groups (ABO/Rh) and sickle cell trait. Malar. J. 23 , 126 (2024). Rout, R. et al. Blood group phenotypes A and B are risk factors for cerebral malaria in Odisha, India. Trans. R Soc. Trop. Med. Hyg. 106 , 538–543 (2012). Rahman, M. & Agrawal, P. Observation on relationship of hepatic and renal dysfunction with haemorrheological parameters in plasmodium falciparum malaria in Kosi region, Bihar, India. Int. J. Adv. Med. https://doi.org/10.18203/2349-3933.ijam20164414 (2017). Degarege, A., Medhin, G., Animut, A., Legess, M. & Erko, B. Association of ABO blood group and P. falciparum malaria related outcomes: A cross-sectional study in Ethiopia. Acta Trop. 123 , 164–169 (2012). Rowe, J. A. et al. Blood group O protects against severe Plasmodium falciparum malaria through the mechanism of reduced rosetting. Proceedings of the National Academy of Sciences 104, 17471–17476 (2007). Aninagyei, E. et al. ABO and Rhesus blood group variability and their associations with clinical malaria presentations. Malar. J. 23 , 257 (2024). Misra, D. P., Das, S., Pattnaik, M., Singh, S. C. & Jena, R. K. Relationship of hepatic and renal dysfunction with haemorrheological parameters in Plasmodium falciparum malaria. J. Assoc. Physicians India . 59 , 552–556 (2011). Kotresh, N. & Suresh, S. Liver function abnormalities in falciparum malaria. Int. J. Adv. Med. 847–850. 10.18203/2349-3933.ijam20163498 (2016). Davies, M. P., Brook, G. M., Weir, W. R., Bannister, B. & Tibbs, C. Liver function tests in adults with Plasmodium falciparum infection. Eur. J. Gastroenterol. Hepatol. 8 , 873–875 (1996). Khan, R., Quaiser, S. & Haque, S. Malarial acute kidney injury: Prognostic markers. Ann. Trop. Med. Public. Health . 6 , 280 (2013). Pati, S. S., Mishra, S. K., Mohanty, S., Pattnaik, J. K. & Das, B. S. Influence of renal impairment on plasma concentrations of conjugated bilirubin in cases of Plasmodium falciparum malaria. Ann. Trop. Med. Parasitol. 97 , 581–586 (2003). Opi, D. H. et al. Non-O ABO blood group genotypes differ in their associations with Plasmodium falciparum rosetting and severe malaria. Preprint at. https://doi.org/10.1101/2022.08.02.501704 (2022). Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 04 May, 2026 Reviewers agreed at journal 04 May, 2026 Reviewers agreed at journal 02 May, 2026 Reviewers agreed at journal 20 Apr, 2026 Reviewers invited by journal 20 Apr, 2026 Editor assigned by journal 17 Apr, 2026 Editor invited by journal 08 Apr, 2026 Submission checks completed at journal 06 Apr, 2026 First submitted to journal 06 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-9294099\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Article\",\"associatedPublications\":[],\"authors\":[{\"id\":629373222,\"identity\":\"95761b5c-603d-4ac8-9986-bb3ae291542b\",\"order_by\":0,\"name\":\"Euclides Sacomboio\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIiWNgGAWjYHACxgMJbHDOAQY2BuYDBPWga2FLIKyFAVkLAwOPAV7l/BLJDw48KLOxZ+A//PDDx5w7cnzsPd8kfu5gkOfHoUVyRprBgYRzaYkNEmnGkjO3PTNm4zm7TbL3DIPhzAbsWgxu5DAcSGw7nMAgwWDGzLvtcGKbRO42Cd42BsYNB7BrsYdo+Q902PFvUC05zyT/tjHY49JiIAHWcoCxgSEHZksOmzTQlkRcWiTOPAP5JRmkshjql2PG1rJtEsm4/MLfnvzw4Y8yO3t+/uMbP3zcdkdOvr354c23bTa2/ThCDA7Y0PgShDSMglEwCkbBKMADAKDpXBrakCzJAAAAAElFTkSuQmCC\",\"orcid\":\"\",\"institution\":\"Universidade Agostinho Neto (ICISA/UAN)\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Euclides\",\"middleName\":\"\",\"lastName\":\"Sacomboio\",\"suffix\":\"\"},{\"id\":629373223,\"identity\":\"4d60509f-5f4c-460d-a8be-2532c6406ec8\",\"order_by\":1,\"name\":\"Cruz S. Sebastião\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Centro Nacional de Investigação Científica (CNIC)\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Cruz\",\"middleName\":\"S.\",\"lastName\":\"Sebastião\",\"suffix\":\"\"},{\"id\":629373224,\"identity\":\"177ceb3d-52a0-4207-9e49-1981410e4e7e\",\"order_by\":2,\"name\":\"Teresa Luzembo\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Universidade Agostinho Neto (ICISA/UAN)\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Teresa\",\"middleName\":\"\",\"lastName\":\"Luzembo\",\"suffix\":\"\"},{\"id\":629373225,\"identity\":\"ad549a88-77fe-48c4-be1d-addbc160a807\",\"order_by\":3,\"name\":\"Edson Cassinela\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Centro Nacional de Investigação Científica (CNIC)\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Edson\",\"middleName\":\"\",\"lastName\":\"Cassinela\",\"suffix\":\"\"},{\"id\":629373226,\"identity\":\"0c84925f-682b-48ca-ad57-29aa85e996e1\",\"order_by\":4,\"name\":\"Eduardo Ekundi-Valentim\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Universidade Rainha Nginga a Mbande (URNM)\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Eduardo\",\"middleName\":\"\",\"lastName\":\"Ekundi-Valentim\",\"suffix\":\"\"},{\"id\":629373227,\"identity\":\"17f71faa-7354-408e-ac63-6efaaab1b434\",\"order_by\":5,\"name\":\"Joana Morais\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Centro de Investigação em Saúde de Angola (CISA)|Instituto Nacional de Investigação em Saúde (INIS)\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Joana\",\"middleName\":\"\",\"lastName\":\"Morais\",\"suffix\":\"\"},{\"id\":629373228,\"identity\":\"4f36644c-0368-4b31-8fa4-3ef3e393426b\",\"order_by\":6,\"name\":\"Fausto Almeida\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Universidade de São Paulo (FMRP/USP)\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Fausto\",\"middleName\":\"\",\"lastName\":\"Almeida\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-04-01 15:53:53\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-9294099/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-9294099/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":108009540,\"identity\":\"ac9046d7-7d83-4e46-8afb-ee170bbbac70\",\"added_by\":\"auto\",\"created_at\":\"2026-04-28 13:10:18\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":164716,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eDistribution of biochemical parameter concentrations in relation to ABO/Rh blood groups. (A) Concentration of creatinine, direct bilirubin, and total bilirubin among ABO/RH blood groups. (B) Concentration of urea and glucose among ABO/RH blood groups. (C) Concentration of ALT(TGP), AST(TGO), and Gamma GT in ABO/RH blood groups.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9294099/v1/4cdb04fa7d2a25aed8ab90fd.png\"},{\"id\":108010701,\"identity\":\"95f609b1-287c-463f-8cf6-b0832b592ca2\",\"added_by\":\"auto\",\"created_at\":\"2026-04-28 13:13:51\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":662426,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9294099/v1/02495c83-5eaa-4acd-8b92-b9b683840a41.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"The role of ABO/RH blood groups in biochemical response among Plasmodium falciparum patients in Luanda, Angola\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eMalaria remains a public health concern in Angola, a sub-Saharan African country, where Plasmodium falciparum accounts for most cases. According to the WHO, Angola consistently ranks among the countries with the highest malaria burden globally, with an estimated 6.6\\u0026nbsp;million cases and over 13,000 deaths reported annually [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. Beyond the immediate clinical presentations of fever, anaemia, and parasitemia, P. falciparum malaria triggers biochemical derangements that reflect multi-organ involvement and predict clinical outcomes.\\u003c/p\\u003e \\u003cp\\u003eThe biochemical complications of severe falciparum malaria are diverse and interconnected. Hyperbilirubinemia, arising from intravascular hemolysis and hepatic dysfunction, is a hallmark of severe disease and correlates with mortality risk [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. Elevated aminotransferases (AST and ALT) signal hepatocellular injury [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e]. Renal dysfunction, manifesting as elevated creatinine and urea, complicates up to 40% of severe cases and significantly worsens prognosis [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e]. Hypoglycemia represents another life-threatening complication [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e], while GGT elevations may reflect cholestatic injury or oxidative stress [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e]. Also, host genetic factors, particularly ABO and Rhesus (Rh) blood group polymorphisms, have emerged as important modulators of malaria susceptibility and severity. Blood group O confers protection against severe malaria, reducing risk by approximately 30\\u0026ndash;50% compared to non-O groups [\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e]. This protective effect operates primarily through reduced rosetting, wherein P. falciparum-infected erythrocytes bind to uninfected red blood cells via parasite ligands such as PfEMP1 [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. The A and B antigens on non-O erythrocytes serve as host receptors for rosetting, facilitating larger and more stable rosette formation [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e]. Rosetting promotes microvascular sequestration, impairs blood flow, and exacerbates tissue hypoxia, thereby driving severe disease manifestations [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. Blood group A has been particularly associated with increased risk of severe malaria, with odds ratios ranging from 1.5 to 2.0 in multiple African cohorts [\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eDespite accumulating evidence that ABO blood groups influence malaria severity and that biochemical derangements predict clinical outcomes, the potential interaction between blood group phenotypes and biochemical responses to P. falciparum infection has not been explored. This study evaluated the impact of ABO and Rh blood groups in modulating biochemical responses to P. falciparum malaria in an Angolan cohort, assessing associations between blood group phenotypes and key biochemical markers, including glucose, creatinine, urea, bilirubin, AST, ALT, and GGT.\\u003c/p\\u003e\"},{\"header\":\"Methodology\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStudy design and setting\\u003c/h2\\u003e \\u003cp\\u003eThis was a cross-sectional study conducted at the Josina Machel and Hospital Geral terciare health units, located in Luanda, the capital city of Angola, between January 2023 and December 2024. The study was conducted in accordance with the guidelines of the Declaration of Helsinki and approved by the Ethics Committee for Research Involving Human Subjects and the Scientific Council of the Institute of Health Sciences at Agostinho Neto University (Approval No. 118/GD/ICISA/UAN/2021, approved on February 25, 2021). Also, consent was obtained from both participating hospitals, Hospital Josina Machel (No. 36/DPC/HJM/2023) and Hospital Geral (No. 272/DPC/HGL/2023). Written informed consent was obtained from all participants or their legal guardians before enrollment and sample collection. From an initial pool of 1,200 patients screened, 518 met the inclusion criteria and were enrolled in the study. Patients under 12 years old, pregnant women, individuals with cerebral malaria, and those presenting comorbidities such as diabetes, hypertension, cardiovascular disease, chronic kidney disease, or HIV infection, as well as patients over 70 years of age, were excluded to minimise confounding factors.\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eLaboratory procedure\\u003c/h3\\u003e\\n\\u003cp\\u003eHospital clinicians using standard clinical criteria performed malaria diagnosis. Then, the research team carried out confirmation through rapid diagnostic tests (SD-Bioline Malaria Ag Pf/PAN) and microscopic examination. Parasitemia was calculated against 200 WBCs according to WHO recommendations. Clinical severity (mild, moderate, severe) was defined following WHO criteria based on symptoms, laboratory findings, and organ involvement. Parasitemia was classified quantitatively according to parasite density per microliter of blood, such as low (\\u0026le;\\u0026thinsp;50 parasites/\\u0026micro;L), moderate (51\\u0026ndash;1,000 parasites/\\u0026micro;L), high (1,001\\u0026ndash;10,000 parasites/\\u0026micro;L), and very high (\\u0026gt;\\u0026thinsp;10,000 parasites/\\u0026micro;L), following WHO guidelines [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003ePeripheral venous blood was collected into EDTA tubes for ABO and Rh blood grouping. Blood group phenotyping was performed by microplate agglutination assay using commercial anti-A, anti-B, and anti-D sera (Immucor, Portugal), following manufactors instrutions.\\u003c/p\\u003e \\u003cp\\u003eBiochemical analyses were performed on serum samples using the Biobase BK-200 automatic biochemical analyzer (model BK-200, serial no. SHY2002220510382, China).\\u003c/p\\u003e \\u003cp\\u003eBiochemical parameters such as creatinine, direct and total bilirubin, urea, glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were measured. Clinical significance was assigned to values deviating more than 10% from established reference ranges of creatinine (0.55\\u0026ndash;1.41 mg/dL), direct bilirubin (\\u0026le;\\u0026thinsp;1.1 mg/dL), total bilirubin (0.23\\u0026ndash;1.32 mg/dL), urea (18.1\\u0026ndash;55.0 mg/dL), glucose (63.1\\u0026ndash;110.0 mg/dL), ALT (18.7\\u0026ndash;36.3 U/L), AST (7.3\\u0026ndash;41.8 U/L), and GGT (4.6\\u0026ndash;66.0 U/L).\\u003c/p\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStatistical analysis\\u003c/h2\\u003e \\u003cp\\u003eData were analysed using SPSS v.31 (IBM SPSS Statistics, USA). Descriptive statistics included means and standard deviations for normally distributed continuous variables and frequencies with percentages for categorical variables. The chi-square and univariate logistic regression were applied to assess associations between categorical variables, and significance was defined as p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05. Graphical data presentations were generated using SigmaPlot version 16.0.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003e \\u003cb\\u003eSociodemographic profile related to ABO/Rh blood group distribution.\\u003c/b\\u003e The demographic characteristics of the study population and their putative association with ABO/Rh blood groups are summarised in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e. A total of 518 patients with \\u003cem\\u003ePlasmodium falciparum\\u003c/em\\u003e malaria were included in the analysis. The ORh+ blood group was the most prevalent (44.6%, 231/518), followed by ARh+ (22.2%) and BRh+ (22.0%). Age distribution showed that the majority of participants were young (58.9%), followed by adolescents (25.5%), adults (11.2%), and elderly individuals (4.4%). Across all age groups, ORh+ remained the dominant blood group, with no statistically significant association between age and ABO/Rh distribution (p\\u0026thinsp;=\\u0026thinsp;0.335). Gender was significantly associated with ABO/Rh blood groups (p\\u0026thinsp;=\\u0026thinsp;0.041). Male patients accounted for 52.3% of the study population and predominated in the BRh- (66.7%), BRh+ (56.1%), ORh- (57.1%), and ORh+ (56.7%) categories, while female patients had higher proportions of ABRh+ (72.2%), ARh- (60.0%), and ARh+ (53.0%) phenotypes. Regarding place of residence, 38.2% of patients lived in urban areas, 25.9% in peri-urban areas, and 35.9% in rural areas. No significant association was observed between area of ​​residence and blood group distribution (p\\u0026thinsp;=\\u0026thinsp;0.142). Occupational status showed that more than half of participants were students (54.2%), followed by informal workers (28.2%), formal workers (11.8%), and unemployed individuals (5.8%). A borderline significant association was observed between occupation and ABO/Rh blood groups (p\\u0026thinsp;=\\u0026thinsp;0.050), with students and informal workers predominating in almost all blood groups.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eSociodemographic characteristics related to ABO/Rh blood group distribution among malaria patients in Angola\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"10\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c10\\\" colnum=\\\"10\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003eDemographic characteristics\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003eN (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"7\\\" nameend=\\\"c9\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003eABO bloods groups\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c10\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eABRh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eARh-\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eARh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eBRh-\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eBRh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eORh-\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003eORh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOverall\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e518(100)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e36(6.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5(1.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e115(22.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e3(0.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e114(22.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e14(2.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e231(44.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eAge Groups\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eTeenegers\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e132(25.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9(25.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e34(29.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e26(22.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e3(21.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e58(25.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.335\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eYougs\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e305(58.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e22(61.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e4(80.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e63(54.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e76(66.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e6(42.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e133(57.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAdults\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e58(11.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2(5.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e14(12.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e9(7.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e4(28.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e29(12.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eElderly\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e23(4.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3(8.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e4(3.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e3(2.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e1(7.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e11(4.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eGender\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e247(47.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e26(72.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3(60.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e61(53.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e50(43.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e6(42.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e100(43.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.041\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e271(52.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e10(27.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2(40.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e54(47.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e2(66.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e64(56.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e8(57.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e131(56.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eResidence Zone\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eUrban\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e198(38.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e13(36.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e42(36.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e2(66.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e48(42.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e1(7.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e91(39.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.142\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePeri-urban\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e134(25.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e8(22.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e22(19.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e30(26.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e5(35.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e68(29.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRural\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e186(35.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e15(41.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3(60.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e51(44.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e36(31.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e8(57.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e72(31.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eWorking Condition\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFormal Worker\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e61(11.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e8(22.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e14(12.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e9(7.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e28(12.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.050\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInformal Worker\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e146(28.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5(13.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e33(28.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e33(28.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e6(42.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e68(29.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eUnemployed\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e30(5.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3(8.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2(40.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e6(5.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e10(8.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e1(7.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e8(3.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStudent\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e281(54.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e20(55.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2(40.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e62(53.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e62(54.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e7(50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e127(55.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"10\\\"\\u003eNote: Bold numbers mean that the results of the test were statistically significant\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cb\\u003eABO/RH blood groups and biochemical response\\u003c/b\\u003e. In the evaluation of the biochemical response of malaria patients according to blood type (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e), we analyzed various biochemical markers in 518 malaria patients, comparing their levels across different ABO/Rh blood groups to understand any associations. About 28% of patients had low creatinine, while 34.7% had high levels. Although the ABRh+ group had the highest percentage of low creatinine cases (41.7%), there was no statistically significant relationship between creatinine levels and blood groups (p\\u0026thinsp;=\\u0026thinsp;0.141). A significant association was observed between direct bilirubin levels and blood groups (p\\u0026thinsp;=\\u0026thinsp;0.024). Most patients (59.1%) had elevated direct bilirubin, especially in the BRh+ (64%) and ORh+ (61.5%) groups. Total bilirubin levels also showed a significant association with blood groups (p\\u0026thinsp;=\\u0026thinsp;0.004). Notably, the ARh- group had the highest proportion of patients with low total bilirubin (80%), while the BRh+ (54.4%) and ORh+ (45%) blood groups tended to have higher total bilirubin levels. AST levels were significantly associated with blood groups (p\\u0026thinsp;=\\u0026thinsp;0.022). The B Rh\\u0026thinsp;+\\u0026thinsp;and O Rh+ groups had the highest percentages of elevated AST. On the other hand, urea, glucose, ALT, and GGT levels did not vary significantly between blood groups (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eABO/RH blood groups and biochemical response among malaria patients in Angola\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"10\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c10\\\" colnum=\\\"10\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003eBiochemical Response\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003eN (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"7\\\" nameend=\\\"c9\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003eABO bloods groups\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c10\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eABRh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eARh-\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eARh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eBRh-\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eBRh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eORh-\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003eORh+\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eOverall\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e518(100\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e36(6.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5(1.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e115(22.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e3(0.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e114(22.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e14(2.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e231(44.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood Creatinine Concentration (mg/dL)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLow(\\u0026le;\\u0026thinsp;0.54 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e145(28.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e15(41.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20(17.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e35(30.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2(14.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e71(30.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.141\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(0.55\\u0026ndash;1.41 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e193(37.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e11(30.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e51(44.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e2(66.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e39(34.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e8(57.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e81(35.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;1.42 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e180(34.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e10(27.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3(60.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e44(38.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e40(35.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e4(28.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e79(34.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood Direct Bilirubin Concentration (mg/dL)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(\\u0026le;\\u0026thinsp;1.1 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e212(40.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14(38.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e4(80.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e51(44.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e2(66.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e41(36.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e11(78.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e89(38.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e0.024\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;1.2 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e306(59.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e22(61.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e64(55.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e73(64.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e3(21.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e142(61.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood Total Bilirubin (mg/dL)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLow(\\u0026le;\\u0026thinsp;0.22 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e128(24.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e6(16.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e4(80.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e23(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e25(21.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e5(35.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e64(27.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e0.004\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(0.23\\u0026ndash;1.32 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e159(30.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18(50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e42(36.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e27(23.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e7(50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e63(27.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;1.33 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e231(44.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e12(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e50(43.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e62(54.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2(14.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e104(45.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood Urea Concentration (mg/dL)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLow(\\u0026le;\\u0026thinsp;18.0 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e92(17.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9(25.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e18(15.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e14(12.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2(14.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e48(20.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.639\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(18.1\\u0026ndash;55.0 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e216(42.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e13(36.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2(40.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e47(40.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e53(47.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e7(50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e93(40.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;55.1 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e206(40.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14(38.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3(60.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e50(43.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e45(40.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e5(35.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e89(38.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood Glucose Concentration (mg/dL)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLow(\\u0026le;\\u0026thinsp;63.0 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e75(14.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4(11.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20(17.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e13(11.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e6(42.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e32(13.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.115\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(63.1\\u0026ndash;110.0 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e313(60.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e21(58.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5(100.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e69(60.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e3(100.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e74(64.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e5(35.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e136(58.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;110.1 mg/dL)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e130(25.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e11(30.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e26(22.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e27(23.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e3(21.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e63(27.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood ALT Concentration (U/L)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLow(\\u0026le;\\u0026thinsp;18.6 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e284(54.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e17(47.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e5(100.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e64(55.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e3(100.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e62(54.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e9(64.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e124(53.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.152\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(18.7\\u0026ndash;36.3 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e38(7.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3(8.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e5(4.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e15(13.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e15(6.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;36.4 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e196(37.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e16(44.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e46(40.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e37(32.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e5(35.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e92(39.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood AST Concentration (U/L)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLow(\\u0026le;\\u0026thinsp;7.2 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e27(5.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3(8.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2(40.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e6(5.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e6(5.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2(14.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e8(3.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003e0.022\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(7.3\\u0026ndash;41.8 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e163(31.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e14(38.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2(40.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e37(32.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e2(66.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e28(24.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e3(21.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e77(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;41.9 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e328(63.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e19(52.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e72(62.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e1(33.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e80(70.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e9(64.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e146(63.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u003cb\\u003eBlood Gama GT Concentration (U/L)\\u003c/b\\u003e\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eLow(\\u0026le;\\u0026thinsp;4.5 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11(2.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e3(2.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e4(3.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e4(1.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c10\\\"\\u003e \\u003cp\\u003e0.571\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNormal(4.6\\u0026ndash;66.0 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e375(72.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e21(58.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e4(80.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e79(68.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e3(100.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e86(75.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e11(78.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e171(74.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHigh(\\u0026ge;\\u0026thinsp;66.1 U/L)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e132(25.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e15(41.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1(20.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e33(28.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003e0(0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e24(21.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e3(21.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e56(24.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c10\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"10\\\"\\u003eNote: Bold numbers mean that the results of the test were statistically significant\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cb\\u003eDistribution of biochemical parameter concentrations in relation to ABO/Rh blood groups.\\u003c/b\\u003e Figure\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003eA presents the distribution of mean concentrations and standard deviation of creatinine, direct bilirubin, and total bilirubin among individuals with different ABO/Rh blood groups. For creatinine, the overall mean among the studied population was 4.48\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;16.36 mg/dL, notably above the upper limit of the normal reference range (0.55\\u0026ndash;1.41 mg/dL). Stratifying by blood group, the ARh- group exhibited the highest mean creatinine level (13.13\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.62 mg/dL), followed by BRh+ (5.51\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;25.55 mg/dL), ORh+ (4.82\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;15.90 mg/dL), and ARh+ (3.72\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.6 mg/dL). Interestingly, only individuals belonging to the BRh- blood group showed a mean creatinine concentration (0.64\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.47 mg/dL) within the reference range. About direct bilirubin, the overall mean was 5.62\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;12.1 mg/dL, well above the normal threshold (\\u0026le;\\u0026thinsp;1.1 mg/dL). Elevated mean values were particularly prominent in the BRh+ (6.98\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.57 mg/dL), BRh- (6.82\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;11.32 mg/dL), and ARh+ (6.82\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;19.68 mg/dL) blood groups. The ARh- blood group presenting the lowest mean value (0.50\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.53 mg/dL), and was the only group with a direct bilirubin concentration within the physiological range. As for total bilirubin, the overall mean was 3.03\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;6.20 mg/dL. The highest values were observed in ARh+ (3.47\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;6.80 mg/dL), BRh+ (3.37\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;5.37 mg/dL), and ORh+ (2.97\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;6.81 mg/dL). Conversely, ARh- (0.35\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;0.34 mg/dL), BRh- (1.32\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;1.88 mg/dL), and ORh- (1.34\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.17 mg/dL) groups exhibited values within or near the normal reference interval (0.23\\u0026ndash;1.32 mg/dL).\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eFigure\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003eB illustrates the distribution of mean serum urea and glucose concentrations across different ABO/Rh blood groups. The overall mean urea level among the studied population was elevated at 81.80\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;95.98 mg/dL, notably exceeding the upper limit of the reference range (18.1\\u0026ndash;55.0 mg/dL). The stratified analysis revealed that only individuals with the BRh- blood group had mean urea concentrations (37.09\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;21.77 mg/dL) within normal reference values. All other blood groups presented elevated mean urea levels, with the A Rh- group displaying the highest mean (155.04\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;119.05 mg/dL), followed by ARh+ (103.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;128.60 mg/dL). In contrast, glucose concentrations remained largely within the physiological reference range (63.1\\u0026ndash;110 mg/dL) across most blood groups, with an overall mean of 100\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;60.0 mg/dL. The ABRh+ group showed a slightly elevated mean glucose level (118\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;127.8 mg/dL), marginally surpassing the upper reference limit.\\u003c/p\\u003e \\u003cp\\u003eBased on the analysis presented in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003eC, the overall mean level of ALT/TGO was 42.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;62.49 U/L, which is above the reference range (26.2\\u0026ndash;36.3 U/L). Among all blood groups, only individuals with the BRh+ phenotype had ALT values within the normal range (34.2\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;33.2 U/L). The lowest mean ALT levels were observed in ARh- (13.64\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;3.5 U/L) and BRh- (14.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;10.5 U/L) individuals, both falling below reference limits. Conversely, elevated ALT levels were found in patients with ORh- (61.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;102 U/L), ARh+ (47.7\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;82.6 U/L), ABRh+ (44.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;54.6 U/L), and ORh+ (44.1\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;60.8 U/L) blood groups. Regarding AST/TGP, the average value among the cohort was 99.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;198 U/L, well above the standard reference (7.3\\u0026ndash;41.8 U/L). Only patients with the ARh- blood group had mean AST levels within the normal range (23.2\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;27.2 U/L). All other blood groups presented elevated AST concentrations, particularly ARh+ (117\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;342 U/L), ABRh+ (106\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;133 U/L), ORh+ (96.8\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;145 U/L), and BRh+ (94.4\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;111 U/L). In the case of GGT, the overall mean was 58.6\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;91.1 U/L, within the laboratory reference range (4.6\\u0026ndash;66.0 U/L). Most blood groups presented mean GGT levels within normal range, except ABRh+ individuals, who showed an elevated mean (78.9\\u0026thinsp;\\u0026plusmn;\\u0026thinsp;149 U/L).\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eTo our knowledge, this study provides the first assessment of how ABO and Rh blood group phenotypes modulate biochemical responses to P. falciparum malaria in Angolan patients. Our results revealed significant associations between blood groups and bilirubin metabolism, as well as markers of hepatocellular injury; on the other hand, they do not show significant relationships with renal function or glucose homeostasis. These findings are important for understanding the pathophysiology of malaria as well as for the development of risk-stratification strategies based on blood groups in African populations.\\u003c/p\\u003e \\u003cp\\u003eThe distribution of blood groups in our cohort, with ORh+ being the most prevalent (44.6%), followed by Arh+ (22.2%) and BRh+ (22%), is consistent with previous reports from Angola and other sub-Saharan African populations [\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. The observed association between blood group distribution and sex (p\\u0026thinsp;=\\u0026thinsp;0.041) among malaria patients deserves further investigation. Although ABO blood groups are inherited independently of sex chromosomes, gender-specific differences in malaria exposure, healthcare-seeking behavior, or survival could influence the observed distribution in a clinical cohort.\\u003c/p\\u003e \\u003cp\\u003eA significant association was observed between blood groups and bilirubin levels. Direct bilirubin showed a significant association with blood group (p\\u0026thinsp;=\\u0026thinsp;0.024), as did total bilirubin (p\\u0026thinsp;=\\u0026thinsp;0.004). Specifically, patients with BRh\\u0026thinsp;+\\u0026thinsp;and O Rh+ blood groups had elevated bilirubin levels, while ARh- appeared to have a protective effect. This pattern is complex and does not align with the established protective effect of blood group O against severe malaria. Several mechanisms may explain these findings. First, hyperbilirubinemia in malaria arises from both intravascular hemolysis and liver dysfunction [\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. The hemolytic component, driven by parasite clearance, immune system-mediated destruction, and oxidative damage to erythrocyte membranes, generates unconjugated bilirubin. The hepatic component reflects impaired conjugation and excretion of bilirubin due to hepatocyte dysfunction, cholestasis, or microvascular obstruction in the liver [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. Our finding that both direct and total bilirubin are associated with blood group suggests that blood group influences hemolytic and hepatic pathways, deserving further studies in this direction. Elevated bilirubin in BRh+ patients is consistent with previous observations that blood group B is associated with increased malaria severity [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]. The blood groups A and B express glycosylated antigens that serve as receptors for P. falciparum rosette ligands [\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e]. Increased rosette formation in group B patients may promote microvascular sequestration in the liver, leading to hepatic hypoxia, hepatocellular dysfunction, and impaired bilirubin metabolism [\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eThe finding that O Rh+ patients also presented elevated bilirubin is unexpected, given the protective effect of blood group O against severe malaria. However, it is important to note that the protection of blood group O operates primarily by reducing rosette formation and severe manifestations of the disease, such as cerebral malaria and multiorgan dysfunction [\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]. Indeed, some studies suggest that, at high levels of parasitemia, O blood group erythrocytes may be more susceptible to hemolysis, potentially negating the protective effect of sequestration [\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e]. This could explain the elevated bilirubin in Rh+ patients in our cohort. On the other hand, blood group A is generally associated with increased malaria severity [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e], however, the Rh- blood group showed lower bilirubin levels in our study. The Rh factor has received less attention than ABO in malaria research, but evidence has suggested that Rh antigens may influence the efficiency of parasite invasion or the immunological recognition of infected cells [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. Elevated AST showed a significant association with blood group (p\\u0026thinsp;=\\u0026thinsp;0.022), indicating that blood group phenotype influences patterns of hepatocellular injury. AST is released by hepatocytes, cardiac myocytes, and erythrocytes during cellular damage, and its elevation in malaria reflects both hepatic dysfunction and hemolysis [\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e]. The pattern of AST elevation among blood groups likely mirrors the bilirubin findings, with groups predisposed to greater rosette formation and microvascular obstruction exhibiting more pronounced hepatocellular injury.\\u003c/p\\u003e \\u003cp\\u003eIt is worth mentioning that AST elevations in malaria are modest compared to viral hepatitis or drug-induced liver injury, reflecting the predominantly hemolytic, rather than hepatocellular, nature of jaundice associated with malaria [\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e]. The fact that ALT did not show significant associations with blood group (p\\u0026thinsp;\\u0026gt;\\u0026thinsp;0.05) corroborates this interpretation, since ALT is more specific to hepatocytes and less influenced by hemolysis [\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e]. The AST/ALT ratio in malaria is frequently elevated, consistent with a mixed hemolytic-hepatic picture [\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eThe absence of significant associations between blood groups and creatinine, urea, glucose, ALT, and GGT requires careful interpretation. For renal function markers (creatinine and urea), several explanations are possible for the absence of associations with blood groups. Acute kidney injury in severe malaria is multifactorial, involving hypovolemia, microvascular obstruction, immune complex deposition, and direct parasite-mediated injury [\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e]. Although rosette formation contributes to microvascular pathology, kidney injury may be less dependent on rosette formation than cerebral or hepatic complications, potentially explaining the lack of association with blood group [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eThe absence of an association between glucose and blood group is consistent with the fact that hypoglycemia in malaria is primarily driven by increased glucose consumption by parasites and host immune cells, impaired hepatic gluconeogenesis, and the effects of medications [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e]. It is unlikely that these mechanisms are strongly influenced by rosette formation or blood group-dependent cytoadherence. Similarly, the absence of associations with ALT and GGT suggests that the effects of blood group on liver function are selective, primarily affecting pathways related to hemolysis and AST release, rather than specific hepatocyte injury (ALT) or cholestatic pathways (GGT) [\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eOur findings support a model in which non-O blood groups, particularly B, promote larger and more stable rosettes, leading to increased hepatic sequestration, hepatocyte hypoxia, and increased hemolysis [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e]. This manifests as elevated bilirubin and AST levels. Therefore, malaria patients with the BRh+ blood group may require more rigorous monitoring of liver function and bilirubin levels.\\u003c/p\\u003e \\u003cp\\u003eThis study has some limitations. Firstly, the cross-sectional design prevents the assessment of temporal dynamics and causal inference. Therefore, longitudinal studies that follow the biochemical changes throughout infection and treatment are needed to clarify how blood group influences disease progression in Angolan population. Secondly, our study was conducted in Luanda, which may limit generalizability to other regions of Angola or malaria-endemic areas with different parasite strains, transmission intensities, or population genetic characteristics. Thirdly, the size of our sample for some blood group and Rh factor combinations, particularly rare phenotypes such as Arh- and ABRh-, was small, reducing statistical power. Finally, genetic heterogeneity within ABO blood groups was not assessed, although recent evidence suggests genotype-specific differences in rosette formation and malaria severity [\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e]. Despite these limitations, our study presents important insights into the modulating role of blood groups in biochemical responses in patients with non-severe malaria, which should be further explored in future longitudinal studies with larger sample sizes and across different regions of Angola.\\u003c/p\\u003e\"},{\"header\":\"Conclusion\",\"content\":\"\\u003cp\\u003eIn conclusion, our study demonstrates that ABO and Rh blood groups significantly modulate biochemical responses to P. falciparum malaria, mainly bilirubin metabolism and markers of hepatocellular injury. B Rh\\u0026thinsp;+\\u0026thinsp;and O Rh+ blood groups are associated with elevated bilirubin levels, while A Rh- appears to have a protective effect.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e \\u003cstrong\\u003eEthics approval and consent to participate\\u003c/strong\\u003e \\u003cp\\u003eThe study was conducted in accordance with the guidelines of the Declaration of Helsinki and approved by the Ethics Committee for Research Involving Human Subjects and the Scientific Council of the Institute of Health Sciences at Agostinho Neto University (Approval No. 118/GD/ICISA/UAN/2021, approved on February 25, 2021), Hospital Josina Machel (No. 36/DPC/HJM/2023) and Hospital Geral (No. 272/DPC/HGL/2023).\\u003c/p\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cstrong\\u003eConsent for publication\\u003c/strong\\u003e \\u003cp\\u003eNot applicable.\\u003c/p\\u003e \\u003c/p\\u003e\\u003cp\\u003e \\u003ch2\\u003eCompeting interests\\u003c/h2\\u003e \\u003cp\\u003eThe authors declare that they have no competing interests.\\u003c/p\\u003e \\u003c/p\\u003e\\u003ch2\\u003eFunding\\u003c/h2\\u003e \\u003cp\\u003eThis project was funded by the European Union and the African Union through the 2022 ARISE-PP-13 Project, which is coordinated by the African Academy of Sciences. Moreover, the project was co-financed by the Science and Technology Development Project (PDCT) of the Ministry of Higher Education, Science, Technology and Innovation of Angola through financial support for research and the design of a Post-doctoral scholarship for the principal investigator.\\u003c/p\\u003e\\u003ch2\\u003eAuthor Contribution\\u003c/h2\\u003e\\u003cp\\u003eConceptualisation: ES and FA. Data curation: ES, CSS, and FA. Formal analysis: ES, CSS, and FA. Funding acquisition: ES and FA. Methodology: ES, TL, and FA Investigation: ES, CSS, TL, EC, EE-V, JM, and FA. Project administration: ES and FA. Supervision: ES and FA. Validation: ES. Writing \\u0026ndash; original draft: ES and CSS. Writing \\u0026ndash; review \\u0026amp; editing: ES, CSS, and FA. All authors have seen and approved the submitted version of this manuscript.\\u003c/p\\u003e\\u003ch2\\u003eAcknowledgement\\u003c/h2\\u003e\\u003cp\\u003eThe authors would like to thank all participants who generously contributed their time to this study. We are also grateful to the management of Prenda Hospital for logistical support as well as the CKS Speed Science for scientific support.\\u003c/p\\u003e\\u003ch2\\u003eData Availability\\u003c/h2\\u003e\\u003cp\\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eWorld Health Organisation (WHO). \\u003cem\\u003eWorld Malaria Report 2023\\u003c/em\\u003e (World Health Organization, 2023).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDas, A., Khan, A. \\u0026amp; Sarma, G. Profile of acute severe malaria with hepatopathy. \\u003cem\\u003eInt. J. Med. Public. Health\\u003c/em\\u003e. \\u003cb\\u003e4\\u003c/b\\u003e, 371 (2014).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eChandra, S., Dhawale, S. \\u0026amp; Chouhan, A. HEPATIC DYSFUNCTION IN FALCIPARUM MALARIA. \\u003cem\\u003eJ. Evol. Med. Dent. Sci.\\u003c/em\\u003e \\u003cb\\u003e4\\u003c/b\\u003e, 184\\u0026ndash;191 (2015).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eChughlay, M. F. et al. Liver Enzyme Elevations in Plasmodium falciparum Volunteer Infection Studies: Findings and Recommendations. \\u003cem\\u003eAm. J. Trop. Med. Hyg.\\u003c/em\\u003e \\u003cb\\u003e103\\u003c/b\\u003e, 378\\u0026ndash;393 (2020).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eEnwere, G. C. et al. Biochemical and haematological variables in Gambian children with cerebral malaria. \\u003cem\\u003eAnn. Trop. Paediatr.\\u003c/em\\u003e \\u003cb\\u003e19\\u003c/b\\u003e, 327\\u0026ndash;332 (1999).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKoopmans, L. C. et al. Acute kidney injury in imported Plasmodium falciparum malaria. \\u003cem\\u003eMalar. J.\\u003c/em\\u003e \\u003cb\\u003e14\\u003c/b\\u003e, 523 (2015).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAhmad, S., HOSPITAL-BASED RETROSPECTIVE COMPARATIVE STUDY OF COMPLICATIONS, O. U. T. C. O. M. E. S. \\u0026amp; CLINICAL AND LABORATORY PARAMETERS OF MALARIA WITH AND WITHOUT NEUROLOGICAL INVOLVEMENT. A. \\u003cem\\u003eMediterr. J. Hematol. Infect. Dis.\\u003c/em\\u003e 9, e2017006 (2016).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePanda, A. K. et al. Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis. \\u003cem\\u003eMalar. J.\\u003c/em\\u003e \\u003cb\\u003e10\\u003c/b\\u003e, 309 (2011).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDegarege, A., Gebrezgi, M. T., Ibanez, G., Wahlgren, M. \\u0026amp; Madhivanan, P. Effect of the ABO blood group on susceptibility to severe malaria: A systematic review and meta-analysis. \\u003cem\\u003eBlood Rev.\\u003c/em\\u003e \\u003cb\\u003e33\\u003c/b\\u003e, 53\\u0026ndash;62 (2019).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eOpi, D. H. et al. Non-O ABO blood group genotypes differ in their associations with Plasmodium falciparum rosetting and severe malaria. \\u003cem\\u003ePLoS Genet.\\u003c/em\\u003e \\u003cb\\u003e19\\u003c/b\\u003e, e1010910 (2023).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRowe, J. A. et al. Blood group O protects against severe Plasmodium falciparum malaria through the mechanism of reduced rosetting. \\u003cem\\u003eProceedings of the National Academy of Sciences\\u003c/em\\u003e 104, 17471\\u0026ndash;17476 (2007).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAfoakwah, R., Aubyn, E., Prah, J., Nwaefuna, E. K. \\u0026amp; Boampong, J. N. Relative Susceptibilities of ABO Blood Groups to Plasmodium falciparum Malaria in Ghana. \\u003cem\\u003eAdv. Hematol.\\u003c/em\\u003e 1\\u0026ndash;4 (2016). (2016).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTadesse, H. \\u0026amp; Tadesse, K. Assessing the association of severe malaria infection and ABO blood groups in northwestern Ethiopia. \\u003cem\\u003eJ. Vector Borne Dis.\\u003c/em\\u003e \\u003cb\\u003e50\\u003c/b\\u003e, 292\\u0026ndash;296 (2013).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePanda, A. K. et al. Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis. \\u003cem\\u003eMalar. J.\\u003c/em\\u003e \\u003cb\\u003e10\\u003c/b\\u003e, 309 (2011).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSacomboio, E. N. M. et al. Blood count changes in malaria patients according to blood groups (ABO/Rh) and sickle cell trait. \\u003cem\\u003eMalar. J.\\u003c/em\\u003e \\u003cb\\u003e23\\u003c/b\\u003e, 126 (2024).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRout, R. et al. Blood group phenotypes A and B are risk factors for cerebral malaria in Odisha, India. \\u003cem\\u003eTrans. R Soc. Trop. Med. Hyg.\\u003c/em\\u003e \\u003cb\\u003e106\\u003c/b\\u003e, 538\\u0026ndash;543 (2012).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRahman, M. \\u0026amp; Agrawal, P. Observation on relationship of hepatic and renal dysfunction with haemorrheological parameters in plasmodium falciparum malaria in Kosi region, Bihar, India. \\u003cem\\u003eInt. J. Adv. Med.\\u003c/em\\u003e \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.18203/2349-3933.ijam20164414\\u003c/span\\u003e\\u003cspan address=\\\"10.18203/2349-3933.ijam20164414\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e (2017).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDegarege, A., Medhin, G., Animut, A., Legess, M. \\u0026amp; Erko, B. Association of ABO blood group and P. falciparum malaria related outcomes: A cross-sectional study in Ethiopia. \\u003cem\\u003eActa Trop.\\u003c/em\\u003e \\u003cb\\u003e123\\u003c/b\\u003e, 164\\u0026ndash;169 (2012).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRowe, J. A. et al. Blood group O protects against severe Plasmodium falciparum malaria through the mechanism of reduced rosetting. \\u003cem\\u003eProceedings of the National Academy of Sciences\\u003c/em\\u003e 104, 17471\\u0026ndash;17476 (2007).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAninagyei, E. et al. ABO and Rhesus blood group variability and their associations with clinical malaria presentations. \\u003cem\\u003eMalar. J.\\u003c/em\\u003e \\u003cb\\u003e23\\u003c/b\\u003e, 257 (2024).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMisra, D. P., Das, S., Pattnaik, M., Singh, S. C. \\u0026amp; Jena, R. K. Relationship of hepatic and renal dysfunction with haemorrheological parameters in Plasmodium falciparum malaria. \\u003cem\\u003eJ. Assoc. Physicians India\\u003c/em\\u003e. \\u003cb\\u003e59\\u003c/b\\u003e, 552\\u0026ndash;556 (2011).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKotresh, N. \\u0026amp; Suresh, S. Liver function abnormalities in falciparum malaria. \\u003cem\\u003eInt. J. Adv. Med.\\u003c/em\\u003e 847\\u0026ndash;850. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.18203/2349-3933.ijam20163498\\u003c/span\\u003e\\u003cspan address=\\\"10.18203/2349-3933.ijam20163498\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e (2016).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDavies, M. P., Brook, G. M., Weir, W. R., Bannister, B. \\u0026amp; Tibbs, C. Liver function tests in adults with Plasmodium falciparum infection. \\u003cem\\u003eEur. J. Gastroenterol. Hepatol.\\u003c/em\\u003e \\u003cb\\u003e8\\u003c/b\\u003e, 873\\u0026ndash;875 (1996).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKhan, R., Quaiser, S. \\u0026amp; Haque, S. Malarial acute kidney injury: Prognostic markers. \\u003cem\\u003eAnn. Trop. Med. Public. Health\\u003c/em\\u003e. \\u003cb\\u003e6\\u003c/b\\u003e, 280 (2013).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePati, S. S., Mishra, S. K., Mohanty, S., Pattnaik, J. K. \\u0026amp; Das, B. S. Influence of renal impairment on plasma concentrations of conjugated bilirubin in cases of Plasmodium falciparum malaria. \\u003cem\\u003eAnn. Trop. Med. Parasitol.\\u003c/em\\u003e \\u003cb\\u003e97\\u003c/b\\u003e, 581\\u0026ndash;586 (2003).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eOpi, D. H. et al. Non-O ABO blood group genotypes differ in their associations with Plasmodium falciparum rosetting and severe malaria. \\u003cem\\u003ePreprint at.\\u003c/em\\u003e \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1101/2022.08.02.501704\\u003c/span\\u003e\\u003cspan address=\\\"10.1101/2022.08.02.501704\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e (2022).\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"scientific-reports\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"scirep\",\"sideBox\":\"Learn more about [Scientific Reports](http://www.nature.com/srep/)\",\"snPcode\":\"\",\"submissionUrl\":\"\",\"title\":\"Scientific Reports\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Scientific Reports\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"ABO/Rh Blood groups, Biochemical markers, Malaria, Plasmodium falciparum, Angola\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-9294099/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-9294099/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cb\\u003eBackground\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eMalaria remains a leading cause of morbidity and mortality in Angola. Host genetic factors, particularly ABO and Rh blood groups, may influence the course of infection, but their role in biochemical responses is not fully understood. Herein, we assess the association between ABO/Rh blood groups and biochemical responses among patients with \\u003cem\\u003ePlasmodium falciparum\\u003c/em\\u003e infection in Luanda, the capital city of Angola.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eMethods\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eThis was a cross-sectional study that enrolled 518 malaria patients. ABO/Rh blood groups and biochemical markers (creatinine, urea, glucose, ALT, AST, GGT, total and direct bilirubin) were measured.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eResults\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eORh\\u0026thinsp;+\\u0026thinsp;was the most prevalent blood group (44.6%), followed by ARh+ (22.2%) and BRh+ (22.0%). Significant associations emerged between ABO/Rh phenotypes and hepatic biochemical markers. Direct bilirubin elevation was significantly associated with blood group (p\\u0026thinsp;=\\u0026thinsp;0.024), with BRh+ (64%) and ORh+ (61.5%) showing highest prevalence. Total bilirubin also demonstrated significant blood group associations (p\\u0026thinsp;=\\u0026thinsp;0.004), with BRh+ (54.4%) and ORh+ (45%) groups exhibiting elevated levels, while ARh- showed predominantly normal values (80%). AST elevation varied significantly by blood group (p\\u0026thinsp;=\\u0026thinsp;0.022), particularly in BRh\\u0026thinsp;+\\u0026thinsp;and ORh+ phenotypes. No significant associations were observed for creatinine, urea, glucose, ALT, or GGT.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eConclusions\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eABO/Rh blood groups modulate hepatic biochemical responses in P. falciparum malaria, particularly bilirubin metabolism and hepatocellular injury markers. These findings suggest blood group phenotypes may influence disease pathophysiology and warrant consideration in risk stratification strategies.\\u003c/p\\u003e\",\"manuscriptTitle\":\"The role of ABO/RH blood groups in biochemical response among Plasmodium falciparum patients in Luanda, Angola\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-04-28 12:58:18\",\"doi\":\"10.21203/rs.3.rs-9294099/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"reviewerAgreed\",\"content\":\"238182103666492386578789463150281441637\",\"date\":\"2026-05-04T16:20:25+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"298226038034495991237137562633589500614\",\"date\":\"2026-05-04T04:31:33+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"170668172431490440660645204940714461958\",\"date\":\"2026-05-02T09:27:35+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"104413065984659678366428500354063138364\",\"date\":\"2026-04-20T08:42:10+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-04-20T07:57:15+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-04-17T07:53:36+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvited\",\"content\":\"\",\"date\":\"2026-04-08T10:58:18+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-04-06T12:22:42+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"Scientific Reports\",\"date\":\"2026-04-06T11:32:54+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"scientific-reports\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"scirep\",\"sideBox\":\"Learn more about [Scientific Reports](http://www.nature.com/srep/)\",\"snPcode\":\"\",\"submissionUrl\":\"\",\"title\":\"Scientific Reports\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Scientific Reports\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"642d602b-115a-41be-9dce-17eceba41b82\",\"owner\":[],\"postedDate\":\"April 28th, 2026\",\"published\":true,\"recentEditorialEvents\":[{\"type\":\"reviewerAgreed\",\"content\":\"238182103666492386578789463150281441637\",\"date\":\"2026-05-04T16:20:25+00:00\",\"index\":85,\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"298226038034495991237137562633589500614\",\"date\":\"2026-05-04T04:31:33+00:00\",\"index\":84,\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"170668172431490440660645204940714461958\",\"date\":\"2026-05-02T09:27:35+00:00\",\"index\":83,\"fulltext\":\"\"}],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[{\"id\":66989744,\"name\":\"Biological sciences/Biochemistry\"},{\"id\":66989745,\"name\":\"Health sciences/Biomarkers\"},{\"id\":66989746,\"name\":\"Health sciences/Diseases\"},{\"id\":66989747,\"name\":\"Health sciences/Medical research\"}],\"tags\":[],\"updatedAt\":\"2026-04-28T12:58:18+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-04-28 12:58:18\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-9294099\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-9294099\",\"identity\":\"rs-9294099\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}