Detection of Weak D (Du) Phenotype among Rh-D Negative Males and Females in Kumasi, Ghana

Abstract

Weak Rh D phenotypes are very frequent in Africans. They are capable of causing alloimmunization in Rh D-negative individuals. Some weak Ds may elude routine typing using direct agglutination techniques. This study aimed at determining the prevalence of weak D phenotype among Rhnegatives, using indirect antiglobulin technique. A total of 400 donors between the ages of 16 and 35 years who were grouped by the blood bank were randomly sampled over a period of 2 months.Three hundred and sixty nine (92.25%) were typed as Rh D-positive and 31 (7.75%) RhD-negative. Two (6.45%) of the Rh D-negative donors were weak D positive while 29 (93.55%) were weak D negative. Among the males 25 (9.43%) were Rh D-negative and 240 (90.57%) RhD-positive. Two (8%) of the 25 males were weak D positive. Among the females, 6 (4.44%) were Rh D-negative and 129 (95.56%) RhD-positive. This implies that, there are people in Kumasi with weak D phenotype which cannot be detected by the direct monoclonal anti-D agglutination. Consequently, indirect antiglobulin test may be indicated for such individuals typed Rh D-negative. This study has shown the need for a comprehensive policy on appropriate testing of donors and newborns, and management of Rh D-negative mothers in the Region. This should include weak D testing of all Rh Dnegative blood donors before transfusion in Rh D-negative patient.

Rhesus Negative Woman Transfused With Rhesus Positive Blood: Subsequent Normal Pregnancy Without Anti D Production

“…Among the donors were 31 Rh D negative individuals with 6.4% of them being weak D. None of the weak Ds were females which could be due to the small number of females; only six. 10 This brings to the fore the need to further investigate individuals who are found to be Rh D negative by the routine serological test to identify those who are weak D before labeling all of them as Rh D negative.…”

Frequency of variant D in Delhi, India

“…reported an incidence as high as 6.45% in African donors. [12] In our study, weak D comprised 0.2% of all D antigen-negative samples and 0.009% of total study population, whereas partial D comprised 0.03% of all D antigen-negative samples and 0.002% of total study population. Various authors have given the prevalence of weak D/partial D in their population.…”

Prevalence of RhD variants among blood donors at Gulu Regional Blood Bank, Gulu, Northern Uganda

“…This finding is comparable to 0.4% that was reported among RhD-negative blood donors in Morocco; 8 however, <4.5% was reported among blood donors in Egypt, 7 2.1% in the donor population at the Regional Blood Transfusion Centre in Kenya 18 and 6.5% among blood donors in Ghana. 9 The difference is attributed to the rather low sample size in our study. The obtained RhD variant phenotype is of great concern considering that this was initially typed as RhD negative, a phenomenon that has been widely attributed to the technique and reagents used.…”

“…The frequency of the RhD variants was reported at 6.45% among Ghanaian blood donors, 4.5% in blood donors of Egypt and 0.4% in blood donors of Morocco. 7 – 9 …”