Epidemiology of ABO and Rhesus blood group frequencies in a Nigerian tertiary hospital: public health and transfusion-relevant patterns

Authors

  • A. O. Daramola
    Department of Haematology and Blood Transfusion, Ekiti State University, Ado-Ekiti, Ekiti State, Nigeria
  • T. J. Ajayi
    Department of Obstetrics and Gynecology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
  • O. S. Olusi
    Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
  • T. V. Olugbade
    Department of Medicine, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
  • E. O. Aina
    Department of Obstetrics and Gynecology, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
  • A. J. Folorunso
    Accident and Emergency Department, Rememer’s Health Centre, Mowe, Ogun State, Nigeria
  • B. M. Rotimi
    Department of Paediatrics and Child Health, Ekiti State University Teaching Hospital, Ado-Ekiti, Ekiti State, Nigeria
  • K. S. Okonji
    Department of Chemistry, Federal University Oye-Ekiti, Oye-Ekiti, Ekiti State, Nigeria;
    Department of Health Sciences, University of the People, Pasadena, CA, USA

Keywords:

ABO blood group, Rh factor, Blood group distribution, Transfusion medicine, Nigeria

Abstract

ABO and Rhesus (Rh) blood group frequencies vary by population and are relevant to transfusion compatibility and blood-bank planning. This retrospective study describes the distribution of ABO and Rh blood groups and their association with age and sex among 6,933 client records handled by the Blood Bank of Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria, during 2023. The cohort comprised 3,538 males (51.0%) and 3,395 females (49.0%); adults (18--64 years) accounted for 79.3% (5,499/6,933). Blood group O was the most frequent ABO phenotype (4,094; 59.1%), followed by A (1,361; 19.6%), B (1,293; 18.7%), and AB (185; 2.7%); 93.2% of clients were Rh-positive. O-positive was the most common combined phenotype (54.9%), and AB-negative was the least common (0.2%). ABO group distribution differed significantly by age group (χ2(12) = 60.8, p < 0.001, Cramer's V = 0.05) and by sex (χ2(3) = 36.9, p < 0.001, Cramer's V = 0.07); both effect sizes were small. Rh status showed no significant association with age (χ2(1) = 0.13, p = 0.714). Blood group O was more frequent among males (62.1%) than females (55.9%), whereas A, B, and AB were modestly more frequent among females. These findings, drawn from a single tertiary-hospital client population that includes donors, transfusion recipients, and routine attendees, provide baseline data to support age- and sex-informed blood-inventory planning and donor recruitment at EKSUTH. Given the cross-sectional, hospital-based design, the findings should not be generalized to the wider Ekiti State or Nigerian population, and any inference about disease susceptibility or survival requires dedicated outcome-based studies. 

Dimensions

[1] G. Daniels, Human blood groups, 3rd ed., Wiley-Blackwell, Oxford, United Kingdom, 2013. https://doi.org/10.1002/9781118493595.

[2] L. Cooling, ``Blood groups in infection and host susceptibility'', Clinical Microbiology Reviews 28 (2015) 801. https://doi.org/10.1128/CMR.00109-14.

[3] U. Latif, A. Seifner & F. L. Dickert, ``Selective detection of erythrocytes with QCMs---ABO blood group typing'', Sensors 23 (2023) 7533. https://doi.org/10.3390/s23177533.

[4] J. R. Storry & M. L. Olsson, ``The ABO blood group system revisited: a review and update'', Immunohematology 25 (2009) 48. https://doi.org/10.21307/immunohematology-2019-231.

[5] M. F. Murphy, D. J. Roberts, M. H. Yazer & N. M. Dunbar (Eds.), Practical Transfusion Medicine, 6th ed., Wiley-Blackwell, Hoboken, USA, 2022. https://doi.org/10.1002/9781119665885.

[6] P. Levine & R. E. Stetson, ``Landmark article July 8, 1939: an unusual case of intra-group agglutination'', JAMA 251 (1984) 1316. https://doi.org/10.1001/jama.251.10.1316.

[7] G. Daniels, ``The molecular genetics of blood group polymorphism'', Human Genetics 126 (2009) 729. https://doi.org/10.1007/s00439-009-0738-2.

[8] H. Lehmann, ``The distribution of the human blood groups and other polymorphisms, by A. E. Mourant, Ada C. Kopec and Kazimiera Domaniewska-Sobczak, 2nd ed. Oxford: Oxford University Press, 1976'', Journal of Biosocial Science 9 (1977) 371. https://doi.org/10.1017/S0021932000011184.

[9] G. Garratty, S. A. Glynn & R. McEntire, ``ABO and Rh(D) phenotype frequencies of different racial/ethnic groups in the United States'', Transfusion 44 (2004) 703. https://doi.org/10.1111/j.1537-2995.2004.03338.x.

[10] S. Periyavan, K. S. Sangeetha, P. Marimuthu, B. K. Manjunath & D. M. Seema, ``Distribution of ABO and Rhesus-D blood groups in and around Bangalore'', Asian Journal of Transfusion Science 4 (2010) 41. https://pmc.ncbi.nlm.nih.gov/articles/PMC2847344/.

[11] U. G. Egesie, O. J. Egesie, I. Usar & T. O. Johnbull, ``Distribution of ABO, Rhesus blood and haemoglobin electrophoresis among the undergraduate students of Niger Delta State University, Nigeria'', Nigerian Journal of Physiological Sciences 23 (2008) 5. https://doi.org/10.4314/njps.v23i1-2.54900.

[12] C. M. Westhoff, ``The Rh blood group system in review: a new face for the next decade'', Transfusion 44 (2004) 1663. https://doi.org/10.1111/j.0041-1132.2004.04237.x.

[13] M. E. Reid, C. Lomas-Francis & M. L. Olsson, The Blood Group Antigen FactsBook, 3rd ed., Academic Press, San Diego, USA, 2012. https://www.sciencedirect.com/book/monograph/9780124158498/the-blood-group-antigen-factsbook.

[14] M. Franchini, G. M. Liumbruno & G. Lippi, ``The prognostic value of ABO blood group in cancer patients'', Blood Transfusion 14 (2015) 434. https://doi.org/10.2450/2015.0164-15.

[15] J. A. Rowe, I. G. Handel, M. A. Thera, M. A. Deans, K. E. Lyke, A. Koné, D. A. Diallo, A. Raza, O. Kai, K. Marsh, C. V. Plowe, O. K. Doumbo & J. M. Moulds, ``Blood group O protects against severe textit{Plasmodium falciparum} malaria through the mechanism of reduced rosetting'', Proceedings of the National Academy of Sciences 104 (2007) 17471. https://doi.org/10.1073/pnas.0705390104.

[16] D. J. Anstee, ``The relationship between blood groups and disease'', Blood 115 (2010) 4635. https://doi.org/10.1182/blood-2010-01-261859.

[17] Y. Wu, Z. Feng, P. Li & Q. Yu, ``Relationship between ABO blood group distribution and clinical characteristics in patients with COVID-19'', Clinica Chimica Acta 509 (2020) 220. https://doi.org/10.1016/j.cca.2020.06.026.

[18] K. J. Jr. Moise, ``Management of rhesus alloimmunization in pregnancy'', Obstetrics & Gynecology 112 (2008) 164. https://doi.org/10.1097/AOG.0b013e31817d453c.

%C. Jericó, S. Zalba-Marcos, M. Quintana-Díaz, O. López-Villar, I. Santolalla-Arnedo, A. Abad-Motos, M. J. Laso-Morales, E. Sancho, M. Subirà, E. Bassas, R. Ruiz de Viñaspre-Hernández, R. Juárez-Vela & J. A. García-Erce, ``Relationship between ABO blood group distribution and COVID-19 infection in patients admitted to the ICU: a multicenter observational Spanish study'', Journal of Clinical Medicine 11 (2022) 3042. https://doi.org/10.3390/jcm11113042.

[19] F. Yamamoto, ``Molecular genetics and genomics of the ABO blood group system'', Annals of Blood 6 (2021) 25. https://doi.org/10.21037/aob-20-71.

[20] Y. He, X. Hong, J. Zhang, J. He, F. Zhu & H. Huang, ``Analysis of the genomic sequence of ABO allele using next-generation sequencing method'', Frontiers in Immunology 13 (2022) 814263. https://doi.org/10.3389/fimmu.2022.814263.

[21] A. F. Anyiam, C. O. Arinze-Anyiam, E. A. Irondi & E. I. Obeagu, ``Distribution of ABO and rhesus blood grouping with HIV infection among blood donors in Ekiti State Nigeria'', Medicine 102 (2023) e36342. https://doi.org/10.1097/MD.0000000000036342.

[22] O. Adienbo, A. Nwafor, J. Egwurugwu & O. U. Akpan, ``The distribution of ABO and Rhesus blood groups among indigenes of Ijaw ethnic group in Niger Delta region, Nigeria'', Global Journal of Pure and Applied Sciences 16 (2010) 349. https://doi.org/10.4314/gjpas.v16i3.62862.

[23] D. Basu, S. S. Datta, C. Montemayor, P. Bhattacharya, K. Mukherjee & W. A. Flegel, ``ABO, Rhesus, and Kell antigens, alleles, and haplotypes in West Bengal, India'', Transfusion Medicine and Hemotherapy 45 (2018) 62. https://doi.org/10.1159/000475507.

[24] G. J. Debele, F. U. Fita & M. Tibebu, ``Prevalence of ABO and Rh blood group among volunteer blood donors at the Blood and Tissue Bank Service in Addis Ababa, Ethiopia'', Journal of Blood Medicine 14 (2023) 19. https://doi.org/10.2147/JBM.S392211.

[25] H. U. Okoroiwu & I. M. Okafor, ``Demographic characteristics of blood and blood components transfusion recipients and pattern of blood utilization in a tertiary health institution in southern Nigeria'', BMC Hematology 18 (2018) 20. https://doi.org/10.1186/s12878-018-0112-5.

[26] O. Adeyemo & O. Soboyejo, ``Frequency distribution of ABO, Rh blood groups and blood genotypes among the cell biology and genetics students of University of Lagos, Nigeria'', African Journal of Biotechnology 5 (2006) 2062.

[27] A. T. Anifowoshe, O. A. Owolodun, K. M. Akinseye, O. A. Iyiola & B. F. Oyeyemi, ``Gene frequencies of ABO and Rh blood groups in Nigeria: a review'', The Egyptian Journal of Medical Human Genetics 18 (2017) 205. https://doi.org/10.1016/j.ejmhg.2016.10.004.

[28] A. Khade, A. Bhosale, A. Sarwankar & P. Jakate, ``Study of prevalence of ABO and Rhesus blood groups in voluntary donors in tertiary care hospital blood centre of western Maharashtra, India'', European Journal of Cardiovascular Medicine 15 (2025) 318.

[29] O. Jahanpour, J. J. Pyuza, E. O. Ntiyakunze, A. Mremi & E. R. Shao, ``ABO and Rhesus blood group distribution and frequency among blood donors at Kilimanjaro Christian Medical Center, Moshi, Tanzania'', BMC Research Notes 10 (2017) 738. https://doi.org/10.1186/s13104-017-3037-3.

[30] S. T. Ndoula, J. J. N. Noubiap, J. R. N. Nansseu & A. Wonkam, ``Phenotypic and allelic distribution of the ABO and Rhesus (D) blood groups in the Cameroonian population'', International Journal of Immunogenetics 41 (2014) 206. https://doi.org/10.1111/iji.12114.

[31] R. Amaddah, G. Beddou, H. Skali, H. Yahyaoui, M. Ait Ameur & M. Chakour, ``Prevalence of blood groups at the blood transfusion center at the Military Hospital Avicenna of Marrakech'', American Journal of Laboratory Medicine 4 (2019) 101. https://doi.org/10.11648/j.ajlm.20190406.13.

[32] S. K. Thakur, S. Singh, D. K. Negi & A. K. Sinha, ``Phenotype, allele and genotype frequency distribution of ABO and Rh(D) blood group among blood donors attending regional blood transfusion centre in Delhi, India'', Bioinformation 19 (2023) 385. https://doi.org/10.6026/97320630019385.

[33] A. Sabir, A. Iftikhar, M. U. Ijaz, G. Hussain, A. Rasul, R. K. Iqbal, F. Sajid & H. Anwar, ``Retrospective study of frequency of ABO and Rhesus blood group among population of Safdarabad and Faisalabad cities of Pakistan'', BMC Research Notes 14 (2021) 12. https://doi.org/10.1186/s13104-020-05429-z.

[34] A. A. Ayenew, ``Prevalence of rhesus D-negative blood type and the challenges of rhesus D immunoprophylaxis among obstetric population in Ethiopia: a systematic review and meta-analysis'', Maternal Health, Neonatology and Perinatology 7 (2021) 8. https://doi.org/10.1186/s40748-021-00129-3.

[35] E. B. Parente, V. Harjutsalo, M. Lehto & the Finnish Diabetic Nephropathy Study Group, ``Relationship between ABO blood groups and cardiovascular disease in type 1 diabetes according to diabetic nephropathy status'', Cardiovascular Diabetology 19 (2020) 68. https://doi.org/10.1186/s12933-020-01038-z.

[36] S. B. Abegaz, ``Human ABO blood groups and their associations with different diseases'', BioMed Research International 2021 (2021) 6629060. https://doi.org/10.1155/2021/6629060.

[37] Z. Chen, S.-H. Yang, H. Xu & J.-J. Li, ``ABO blood group system and coronary artery disease: an updated systematic review and meta-analysis'', Scientific Reports 6 (2016) 23250. https://doi.org/10.1038/srep23250.

[38] O. O. Omotade, A. A. Adeyemo, C. M. Kayode, S. L. Falade & S. Ikpeme, ``Gene frequencies of ABO and Rh (D) blood group alleles in a healthy infant population in Ibadan, Nigeria'', West African Journal of Medicine 18 (1999) 294. Available online: https://pubmed.ncbi.nlm.nih.gov/10734795/.

[39] S. Smith, I. Okai, C. S. Abaidoo & E. Acheampong, ``Association of ABO blood group and body mass index: a cross-sectional study from a Ghanaian population'', Journal of Nutrition and Metabolism 2018 (2018) 8050152. https://doi.org/10.1155/2018/8050152.

[40] B. Legese, M. Shiferaw, W. Tamir & T. Tiruneh, ``Distribution of ABO and Rhesus blood group phenotypes among blood donors at Bahir Dar Blood Bank, Amhara, Northwest Ethiopia: a retrospective cross-sectional study'', Journal of Blood Medicine 12 (2021) 849. https://pubmed.ncbi.nlm.nih.gov/34557052/.

[41] G. Garratty, ``Blood groups and disease: a historical perspective'', Transfusion Medicine Reviews 14 (2000) 291. https://doi.org/10.1053/tmrv.2000.16228.

[42] S. P. O. Akogu, O. I. Olumorin & S. E. Akor, ``Distribution of ABO, Rhesus factor blood phenotype and haemoglobin genotype among antenatal clinic attendees in Anyigba, North Central Nigeria'', European Journal of Medical and Health Sciences 3 (2021) 11. https://doi.org/10.24018/ejmed.2021.3.6.954.

[43] E. Oladele, T. O. Yahaya, O. O. Adewumi, B. David & A. J. Oladipo, ``Distribution of ABO/Rhesus blood groups among hepatitis B virus (HBV)-positive patients in Lagos, South-Western, Nigeria'', FUDMA Journal of Sciences 4 (2020) 197. https://doi.org/10.33003/fjs-2020-0403-127.

fig 3

Published

2026-08-20

How to Cite

Epidemiology of ABO and Rhesus blood group frequencies in a Nigerian tertiary hospital: public health and transfusion-relevant patterns. (2026). African Scientific Reports, 5(3), 585. https://doi.org/10.46481/asr.2026.5.3.585

Issue

Volume 5, Issue 3, December 2026 (In progress)

Section

HEALTH & MEDICAL SCIENCES SECTION
Copyright & Licensing

Copyright (c) 2026 A. O. Daramola, T. J. Ajayi, O. S. Olusi, T. V. Olugbade, E. O. Aina, A. J. Folorunso, B. M. Rotimi, K. S. Okonji

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Epidemiology of ABO and Rhesus blood group frequencies in a Nigerian tertiary hospital: public health and transfusion-relevant patterns. (2026). African Scientific Reports, 5(3), 585. https://doi.org/10.46481/asr.2026.5.3.585

Similar Articles

11-20 of 128

You may also start an advanced similarity search for this article.