Northern Nigeria has the highest burden of sickle cell disease patients with frequent transfusion needs. This increases the risk of alloimmunization and hemolytic transfusion reactions. Only ABD blood group typing and crossmatching are available for pre-transfusion compatibility testing. After positive crossmatch red cell alloantibodies cannot be differentiated. Therefore, hospital staff donors were genotyped to establish an antibody screening and differentiation panel.

Blood samples from blood group O staff donors at Aminu Kano Teaching Hospital, Kano, were collected. AB0 and Rhesus DCcEe antigens were typed serologically. DNA was prepared and genotyped for red cell antigens by MALDI-TOF mass spectrometry.

A total of 165 blood samples were investigated and predicted with 100% prevalence for Rhesus c, e, Fy0, Lu^b, Co^a, Yt^a, Kp^b, Vel, Lu8, LW^a, In^b, Sc1, Kn^a, Yk^a; none of the donors was predicted positive for Fy^a, Fy^b, Fy^x, K, Lu^a, Yt^b, Kp^a, Lu14, LW^b, In^a, Sc2, Mt^a. Two donors were predicted Js^b negative, and two others U negative. Based on the immunogenicity of red cell antigens the highest risk for alloantibody development can be expected against Rhesus antigens (prevalence D 94.5%, C 13.9%, E 13.9%), followed by Anti-Jk^b (prevalence Jk^b 44.8%) and anti-S (prevalence S 35.8%). Panel antigrams for both antibody screening and differentiation (Figure) have been designed.

For the first time a red cell antibody differentiation test cell panel for Northern Nigeria is available to identify red cell alloantibodies and to start building a red cell typing plasma bank. Genotyping results indicate that anti-C and anti-E alloimmunization is the highest risk for transfusion recipients in Kano region, Nigeria.

This project is funded by financial means of the German Federal Ministry for Economic Cooperation and Development (BMZ) and supported by the funding program Hospital Partnerships of the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ).