East East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, Issue. 2, 1-10 *Corresponding author: Email: basliel2018@gmail.com, +251 938949495 https://dx.doi.org/10.4314/eajbcs.v3i2.1S Phenotypic and Allelic Distribution of the ABO and Rhesus Blood Groups among students at Hawassa University, Ethiopia Mihret A. Hailu, Wendawek A. Mengesha, and Zelalem G. Tolesa*. Department of Biology, College of Natural and Computational Sciences, Hawassa University, P.O.Box 05 KEYWORDS: ABO blood; Allele frequency; Ethiopia; Phenotypic frequency; Rh blood ABSTRACT A prior information on the distribution of ABO and Rh groups is imprtant for management of bld bank and transfusion, genetic counseling, anthropological studies, to study the association of blood groups and diet; to investigate the association between blood and diseases. This study intended to estimate the frequency of ABO and Rh bloods and investigate gene diversity at both loci among students in Ethiopia. A descriptive cross- sectional survey was employed involving randomly selected two thousand thirty nine (2039) university students (1054 males and 985 females) with an age range of 18–29 years. Blood groups were determined based on agglutination reaction. The most abundant blood group was found to be O (42.47%), followed by A (27.86%), B (21.87%), and AB (7.80 %). The frequency of Rh+ and Rh- were 90.88% and 9.12 %, respectively. The combined blood types showed O+, A+, B+ and AB+ were: 38.60 %, 25.20%, 20.10% and 7.00%, respectively. Slightly different distribution pattern of ABO blood group was observed among females from Amhara region (O> B> A>AB). The distribution of ABO phenotypes from Addis Ababa and Amhara did not differ significantly from those expected under the Hardy Weinberg Equilibrium. A high level of gene diversity was observed for both loci. In general, the O blood type is most frequent and followed by A, B and AB. A similar pattern of distribution of the ABO and Rh blood groups was found in male and female study subjects. The present study will generate a baseline data that could be used in blood bank management and transfusion, genetic counseling, population genetic and anthropological studies, and for disease management. INTRODUCTION The knowledge on the distribution of ABO and Rh groups is important for the management of blood bank and transfusion, genetic counseling, population genetics, and anthropological studies (Liu et al., 2017; Canizalez-Román et al., 2018) and to study the association of blood groups and diet, to relate the association between blood and diseases (Puryear, 2017). Individuals with the O blood type are thought to be resistant to viral disease (Zhao et al., 2021) but susceptible to some bacterial infections (Harris et al., 2005) and Hepatitis B virus (Jing et al., 2020). People with the A blood group have a higher risk, whereas people with blood group O have a East African Journal of Biophysical and Computational Sciences Journal homepage : https://journals.hu.edu.et/hu-journals/index.php/eajbcs Hawassa University College of Natural & Computational Sciences Year 2021 Volume xx No xx Research article mailto:mereba480@gmail.com https://dx.doi.org/10.4314/eajbcs.v3i2.1S East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 2 lower risk for SARS-Cov-2 infection and COVID-19 severity (Zhao et al., 2021). The frequencies of ABO and Rh blood groups differ with ethnicity, geographical locations, race, population movements, natural selection and genetic drift. In the USA, and Mexico the O type is the most frequent, followed by A, B and AB (Garratty et al., 2004; Canizalez-Román et al., 2018). Nevertheless, in China (Liu et al., 2017), type A is the most common, followed by O, B and AB. In southeast Asia, A and B blood groups were interchangeably taking the most common blood group place, while AB was the least common (Dewan, 2015). Type O is the most frequent whereas AB is less common in most African countries (Ndoula et al., 2014; Anifowoshe et al., 2017). The frequency of Rh- blood is less or rare in African and Asian countries (Anifowoshe et al., 2017; Liu et al., 2017). The available limited data indicate that the O blood is more frequent but AB is least common in Ethiopia (Golassa et al., 2017; Fufa and Debelo, 2019). To date in Ethiopia, there are limited works done on the distribution of ABO and Rh blood groups and the most are small scale in terms of sample size and regional coverage (Golassa et al., 2017; Fufa and Debelo, 2019). In this work, however, the subjects were originated from almost all regions in the country and relatively bigger sample size of the study subjects involved in the study. Therefore, this study intended to eatimate the distribution of ABO and Rh bloods and investigate gene diversity of both loci among students in Ethiopia. It is expected that the data may partly contribute to strategies of supply and demand of blood products in transfusion services countrywide and could have consequences in investigating vulnerability to various disease conditions known to be connected with the blood groups. MATERIALS AND METHODS Study area and study subjects The study was conducted in four campuses (College of Agriculture, Main Campus, Institute of Technology and; College of Medicine and Health Sciences) of Hawassa University. It is assumed that the regional and ethnic diversity of the Ethiopian population could be represented in the university student population. In Ethiopia students from different regions are randomly allocated to federal universities in the country, we therefore, believe that, student populations in Hawassa University could represent the regional and ethnic diversity in Ethiopia. Ethiopia has eleven regional States and two city administrations. A descriptive cross-sectional survey was employed involving randomly selected two thousand thirty nine (2039) students (1054 males and 985 females) with an age range of 18–29 years. The selected study subjects originally came from eight regional states (Afar, Amhara, Benishangul Gumuz, Gambela, Oromia, Southern Nation Nationalities and People State (SNNPRS), Somali and Tigray) as well as from Addis Ababa (AA) and Dire Dawa (the two city administrations). The inclusion criteria for the study were: Ethiopian students who are above 18 years old and willing to participate in this study. Blood group determination The ABO and Rh blood group testing was done in the Hawassa University students’ clinics, using a commercially available kit for blood East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 3 grouping (Human Diagnostic, Germany). Briefly, blood samples were collected from the tip of volunteers’ finger, a drop of anti-A, anti-B and anti-D human sera was then added into 5% suspension of the collected blood (in principle the red blood cell) in normal saline within test tubes. The mixture was gently stirred with glass rods, and blood groups of the tested individuals were determined based on agglutination reaction. Allelic frequency and gene diversity analysis The frequencies of the IA allele (p1), IB allele (p2) and IO allele (p3) were calculated based on the extension of Hardy-Weinberg Equilibrium (HWE) for multiple alleles with two co- dominant allele and one recessive allele (Hamilton, 2009). Genotypic frequencies were calculated under HWE assumptions as [(p1 + p2 + p3) 2 = p1 2+ p2 2 + p3 2 + 2 p1p2 + 2 p1p3 + 2 p2 p3 = 1]as p1 2 (IAIA) + 2 p1p3 (I AIO) + p2 2 (IBIB) + 2 p2 p3 (IBIO) + 2 p1p2 (IAIB) + p3 2 (IOIO). Nevertheless, the Rh system alleles “D” and “d” were allocated q1 and q2, respectively, and their occurrences were also computed using HWE for two allele system [(q1 + q2) 2 = q1 2+ 2 q1q2 + q2 2 = 1 ] as q1 2(DD), 2 q1q2 (Dd), q2 2 (dd). Gene diversity (He) was analyzed according to Nei (1973). Percentage was used to express blood group phenotypic frequencies whereas allele frequencies were estimated/projected using the assumption of Hardy–Weinberg Equilibrium (HWE). The Chi - square test was used to compare observed allelic and genotypic frequency distributions of the blood group and Rh antigens to that expected under the HWE (Hamilton, 2009). The level of statistical significance was at p<0.05. Ethical Approval The study was carried out after getting ethical approval of the Institutinal Review Bard (IRB) of Hawassa University (Ethiopia), College of Natural and Computational Sciences (Ref. No. IRB/203/11; Date: 05/03/2019). Accordingly, the study objectives were explained to students, and written consent for participation in the study was obtained. RESULTS Distribution of ABO and Rh blood groups The frequencies of O, A, B and AB blood types among the participants were: 42.47%, 27.86, 21.87% and 7.80, respectively. The O blood group had the highest frequency while blood group AB had the least frequency (Table1). The study showed that the ABO blood group pattern was in the order of O > A > B > AB. Statistically, no significant variation was noted in the proportions of the A, B, O and AB blood groups among the considered regions (χ2 0.05, 12 = 15.055; p < 0.05). But there were slight differences in the frequencies of ABO blood types. In terms of each blood type the highest proportion of the A phenotype (30.12%), the B phenotype (25.47%) and O phenotype (44.04%) was observed in SNNPRS, Amhara and Addis Ababa, respectively (Table1). The proportion of ABO blood antigens significantly different from those anticipated under Hardy–Weinberg Equilibrium (HWE) (χ2 0.05, 1 = 10.498; p < 0.05) for the combined data set, Oromia region (χ2 0.05, 1 = 7.304; p < 0.05), SNNPRS (χ2 0.05, 1 = 6.027; p < 0.05) and ‘Others’ (χ2 0.05, 1 = 4.248; p < 0.05), respectively. However, the distributions in Addis Ababa (χ2 0.05, 1 = 1.063; p < 0.05) and Amhara (χ2 0.05, 1= 0.004, p < 0.05) did not deviate from HWE. East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 4 Table- 1: Phenotypic frequency of the ABO Blood groups and Rh system based on regions/ towns Regions ABO Blood Rh System N** Type A (%) TypeB (%) TypeAB (%) TypeO (%) Rh + (%) R – (%) Addis Ababa 234 62(24.50) 52(22.22) 17(7.26) 103(44.04) 202(86.32) 32(13.68) Amhara 691 185(26.77) 176(25.47) 44(6.37) 286(41.39) 635(91.90) 56(8.10) Oromia 603 167(27.69) 128(21.23) 53(8.79) 255(42.29) 554(91.87) 49(8.13) SNNPRS 437 132(30.21) 77(17.62) 36(8.22) 192(43.94) 393(89.93) 44(10.07) Others * 74 22(28.57) 13(17.57) 9(12.16) 30(40.54) 69(93.24) 5(6.76) Total 2039 568 (27.86) 446(21.87) 159(7.80) 866(42.47) 1853(90.88) 186(9.12) *Afar(1,1,0,2/3,1), Benishangul Gumz (1,1,1,5/8,0), Dire Dewa (1,2,0,1/4,0), Gambela (1,1,0,1/3,0), Somali (3,2,1,4/7,3)and Tigray(15,6,7,17/44,1). Numbers in the parenthesis are the numbers of individuals with ABO/Rh system, respectively. **sample size. The frequency of allele O was larger as compared to alleles A or B (p3>p1>p2). A comparable higher level of gene diversity was found in each region for both loci (Table2). Table- 2: Allelic frequencies and Gene diversity of ABO blood group and Rh systems Region/City ABO allele Rh allele ABO Rh ABO* Rh* P1 P2 P3 q1 q2 He He HS HT DST GST HS HT DST GST AA 0.186 0.16 0.65 0.63 0.37 0.51 0.47 Amhara 0.182 0.17 0.64 0.76 0.24 0.52 0.37 Oromia 0.203 0.16 0.63 0.72 0.29 0.53 0.41 SNNPRS 0.215 0.14 0.65 0.68 0.32 0.52 0.43 Others 0.238 0.14 0.62 0.74 0.26 0.54 0.39 0.54 0.51 0.04 0.07 0.41 0.42 0.004 0.01 *The figures are for the entire population. He:gene diversity in a subpopulation; HS: average gene diversity within subpopulation; HT: gene diversity for the entire population; DST: gene diversity among subpopulation; GST: Gene differentiation among subpopulation; AA; Addis Ababa; SNNPRS: Southern Nation Nationalities People Regional State The Rh+ blood group comprised 90.88% for the overall data set (Table 1). The highest frequency of Rh+ (93.00%) was observed for ‘other’ group and least was for Addis Ababa (86.32%). In Addis Ababa the frequencies of Rh+ and Rh- were 86.32 % and 16.68%, respectively. The largest frequency of q1 allele and lowest level of gene diversity was observed in Amhara (Table2). The expected gene diversity was highest in Addis Ababa and the lowest from ‘others’ (Table 2). For the ABO locus, the highest frequency of gene diversity was observed in the ‘others’ groups (He= 0.535) but the lowest was in Addis Ababa (He = 0.512). East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 5 The sex specific allele frequency is similar in male and female participants (Table3). A unique phenotypic (O > B > A > AB) was observed for females in Amhara. Table- 3: Phenotypic, allelic frequencies and gene diversity of ABO blood based on sexes [Male (M); Female (F)] Regions Sexes ABO blood type Allelic frequencies* N A (%) B (%) AB (%) O (%) p1 P2 p3 He Addis Ababa M 119 31(26.05) 27(22.68) 7(5.88) 54(45.37) 0.175 0.155 0.670 0.496 F 115 31(26.95) 25(21.73) 10(8.69) 39(33.91) 0.254 0.220 0.526 0.610 Amhara M 325 89(27.38) 77(23.69) 22(6.76) 137(42.15) 0.189 0.166 0.645 0.521 F 366 96(26.22) 99(27.04) 22(6.01) 149(40.71) 0.177 0.182 0.641 0525 Oromia M 320 86(26.87) 70(21.87) 23(7.18) 141(44.06) 0.188 0.158 0.654 0.512 F 283 81(28.62) 58(20.49) 30(10.60) 114(40.28) 0.220 0.170 0.610 0.551 SNNPRS M 249 75(30.12) 37(14.85) 21(8.43) 116(46.58) 0.216 0.124 0.660 0502 F 188 57(30.31) 40(21.27) 15(7.97) 76(40.42) 0.214 0.159 0.627 0.536 Others M 39 11(28.20) 7(17.94) 4(10.25) 17(43.58) 0.215 0.153 0.632 0.531 F 35 12(34.28) 7(20.00) 4(11.42) 12(34.28) 0.263 0.172 0.565 0.585 Total M 1054 292(27.70) 218(20.68) 78(7.40) 466(44.21) 0.194 0.152 0.654 0.512 F 985 276(28.02) 228(23.14) 81(8.22) 400(40.60) 0.201 0.190 0.609 0.553 *Sex specific allelic frequencies AB negative case was not observed from Addis Ababa. The highest frequency for B+ was from Amhara while O+ was highest for Oromia. The O+ was observed more than one third of the population, while AB- was recorded in less than 1% (Table 4). Table- 4: Phenotypic frequencies of ABO blood types based on the Rh system Regions/town N* Phenotype (%) A+ A- B+ B- AB+ AB- O+ O- Addis Ababa 234 52(22.22) 10(4.27) 50(21.4) 2(0.85) 17(7.30) 0(0.00) 83(35.47) 20(8.54) Amhara 691 171(24.70) 14(2.00) 159(23.00) 17(2.5) 40(5.80) 4(0.60) 265(38.40) 21(3.00) Oromia 603 150(24.9) 17(2.8) 117(19.4) 11(1.80) 48(8.00) 5(0.80) 239(39.40) 16(2.70) SNNPRS 437 120(27.50) 12(2.70) 71(16.20) 6(1.40) 30(6.90) 6(1.40) 172(39.40) 20(4.60) Others 74 21(28.37) 1(1.35) 12(16.23) 1(1.35) 8(10.81) 1(1.35) 28(37.33) 2(2.70) Total 2039 514(25.20) 54(2.60) 409(20.10) 37(1.80) 143(7.00) 16(.80) 787(38.60) 79(3.90) *N: Sample size (number of students examined) East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 6 The proportions of the ABO/Rh blood groups were significantly different among the five regions (χ2 0.05, 28 = 43.033; p <0.05). There was a clear variation in the frequency distribution of the blood types between males and female subjects among the regions. For instance, the frequency of the A+ and O+ blood type showed a difference between the male and female from Addis Ababa (Table5). Table- 5: Phenotypic frequencies of ABO blood types based on the Rh system for male (M) and female (F) subjects Regions/city Sex N* Phenotype (%) A+ (%) A-(%) B+ (%) B-(%) AB+ (%) AB-(%) O+ (%) O-(%) Addis Ababa M 119 25(10.70) 6(2.60) 26(21.84) 1(.84) 7(5.88) 0(0.00) 46(38.65) 8(6.72) F 115 27(24.35) 4(3.47) 24(20.86) 1(0.86) 10(8.69) 0(0.00) 37(32.17) 12(10.43) Amhara M 325 82(25.23) 7(2.15) 68(20.92) 9(2.76) 21(6.46) 1(0.31) 131(40.31) 6(1.84) F 366 89(24.32) 7(1.91) 91(24.86) 8(2.18) 19(5.19) 3(0.81) 134(36.61) 15(4.10) Oromia M 320 80(25.00) 6(1.87) 65(20.31) 5(1.56) 20(6.25) 3(0.93) 131(40.93) 10(3.12) F 283 70(24.73) 11(3.88) 52(18.37) 6(2.12) 28(9.82) 2(0.63) 108(38.16) 6(2.12) SNNPRS M 249 70(28.11) 5(2.01) 35(14.05) 2(0.80) 18(6.12) 3(1.20) 104(41.76) 12(4.81) F 188 50(26.59) 7(3.72) 36(19.15) 4(2.13) 12(6.38) 3(1.59) 68(36.17) 8(2.25) Others M 41 11(26.82) 0(0.00) 7(17.07) 0(0.00) 4(9.75) 1(2.43) 17(41.46) 1(2.43) F 33 10(30.30) 1(3.03) 5(15.15) 1(3.03) 4(12.12) 0(0.00) 11(33.33) 1(3.03) Total M 1054 268(25.42) 24(2.27) 201(19.07) 17(1.61) 70(6.64) 8(0.76) 428(40.60) 37(3.51) F 985 246(24.97) 30(3.05) 208(21.11) 20(2.03) 73(7.41) 8(0.81) 358(36.34) 42(4.26) *N: Sample size (number of students examined) DISCUSSION AND CONCLUSIONS Distribution of AB and Rh bld groups The frequency distribution of ABO blood group differs from race to race, population to population and differs in different geographical areas. This study could serve as an initial countrywide report, as the participants were recruited from a national university accepting students from all corner of the country and representing the Ethiopian population. Ethiopia has a rich cultural, linguistic, and ethnic diversity and is home to over 70 different ethnic groups and over 80 living languages (Pagani et al., 2012, 2015). Therefore, Ethiopia is an important region for studying how genetic diversity and differentiation correlate with linguistic and cultural diversity. Furthermore, the knowledge on the distribution of ABO and Rh groups is important for management of blood bank and transfusion, genetic counseling, population genetics and anthropological studies and to study the association of blood groups and diet, to relate the association between blood and diseases (Dewan, 2015; Liu et al., 2017; Puryear, 2017; Canizalez-Román et al., 2018). The proportion of AB blood was relatively larger compared to previous studies in Ethiopia East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 7 (Tesfaye et al., 2015; Fufa and Debelo, 2019), this could be due to the wider sampling regions covered in this study (Table1). The distribution pattern of ABO blood group of females from Amhara seems similar to that of the Bengali population in Bangladesh (Dewan, 2015). Golassa et al. (2017) found two patterns of ABO Phenotypes O>A>B>AB [Nilotic people] and A>O>B>AB [‘Highlanders] in Gambela, southwestern Ethiopia. The results of this study are similar to that of previous studies in Cameroon (Ndoula et al., 2014), Nigeria (Anifowoshe et al., 2017), and Mexico (Canizalez-Román et al., 2018). However, the distribution differs from reports made in Egypt (Abdelmonem et al., 2019), China (Liu et al., 2017), and Bangladesh (Dewan, 2015). Most of the participants in the current study were Rh+ (90.88%), while the rest were Rh- (9.12%). In general, the frequency of Rh- blood is less or rare in African and Asian countries (Liu et al., 2017; Abdelmonem et al., 2019). Golassa et al. (2017), however, reported a relatively higher frequency of Rh- (19.37%) in Gambela, southwestern Ethiopia. The overall frequency of Rh+ in the current study is comparable to Egypt (Abdelmonem et al., 2019), whereas lower compared to Cameroon (Ndoula et al., 2014), and Nigeria (Anifowoshe et al., 2017). The proportion of Rh+ in Addis Ababa is similar to white non-Hispanic in USA (Garratty et al., 2004), but large relative to Gambela (Golassa et al., 2017). The proportion of Rh- ranged from 7-14%, which is wider relative to studies done in Ethiopia (Tesfaye et al., 2015; Fufa and Debelo, 2019). Such a large range in the proportion of Rh- in this study could reflect wider regional coverage – the participants are almost from all the regions of the country. The proportions of O+, A+, B+ and AB+ were: 38.60%, 25.20%, 20.10% and 7.00%, respectively. There was variation in the distribution of ABO/Rh between regions. The proportion of B+ was higher in the Amhara but O+ was higher in the Oromia (Table 4). The O+ frequency was found to be over one third of the entire population, while AB- was recorded in less than 1% of the study population. Similarly, in Cameroon (Ndoula et al., 2014), the O+ blood group is highly predominant, representing about half of the entire population, while AB- is very infrequent. Allelic and genotypic diversity The order of the ABO allele frequency was IO>IA> IB, and similar to earlier studies (Ndoula et al., 2014; Anifowoshe et al., 2017), but differs from Bangladesh (Dewan, 2015), and in Egypt (Abdelmonem et al., 2019).The frequency of q1 allele in this study is lower compared to that of Nigeria (Anifowoshe et al., 2017). However, a higher level of among subpopulation gene diversity (DST) and gene differentiation (GST) was found to be comparable to Mexican populations at both loci (Canizalez-Román et al., 2018). The higher level of gene diversity supports the hypothesis that Ethiopia is an important region for studying how genetic diversity and differentiation correlate with linguistic and cultural diversity (Pagani et al., 2012, 2015). The distribution of ABO phenotypes for Addis Ababa city and Amhara are not significantly different from those expected under the HWE. If a population is in a HWE the genotypic frequency will remain stable unless the equilibrium is perturbed. That would be a good opportunity for the management of blood banks as the frequencies of the blood groups will be stable East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 8 generation after generation (Ndoula et al., 2014; Canizalez-Román et al., 2018). Participants from different regions showed a similar pattern of distribution for both loci which may reflect the complex processes, population admixing among the regions (Hamilton, 2009; Dewan, 2015; Canizalez- Román et al., 2018). Although the general pattern of distribution of the ABO and Rh blood type was similar among different populations, there are also slight differences in the frequencies of different blood types, genotypes and allele frequencies. Such differences of in the phenotypic, genotypic and allelic frequencies could be due to differences in the culture, geography, endemic diseases or population admixture (Hamilton, 2009; Dewan, 2015; Canizalez-Román et al., 2018). Some of these factors could put a selective pressure in favoring one allele over the other and could shape the genetic structure of the ABO and Rh loci of populations in the respective areas in a long term. Furthermore, the low level of gene differentiation observed among subpopulations, could be due to complex population admixture among regions (Dewan, 2015; Canizalez- Román et al., 2018). Association between blood groups and diseases The higher frequency of O blood group observed in this study could have an evolutionary advantage in conferring resistance to disease like malaria. In malaria prone countries of Africa group O are dominant with the distribution ranging from 40.0% to 80.0 % (Cserti and Dzik, 2007). As Ethiopia is a malaria endemic area in the sub-Saharan Africa (Anstee, 2010; Golassa et al. 2017), the dominance of O blood type in the present study, could be advantageous for protection against protozoan diseases (Harris et al., 2005; Panda et al., 2011). Tekeste and Petros (2010) reported a strong association between ABO blood group distribution and the prevalence of malaria in three malaria endemic areas in Ethiopia. The same authors have found among study participants with severe malaria the most frequent blood is type A, whereas among the healthy control groups the most common blood type is O. Similarly, a study done by Panda et al. (2011) in India found that the most common blood type is B among participant with severe malaria in while blood type O is the most frequent blood type among the healthy control groups. Both of these studies support the hypothesis that O blood confers protection to severe malaria albeit the exact mechanism of protection is not well understood and needs further investigation. A review made by Rowe et al. (2009) on the association between falciparum malaria and ABO blood group support the hypothesis that non-O blood groups emerging as significant risk factors for life- threatening malaria, through the mechanism of enhanced rosette formation. Although the O blood is hypothesized to give protection against malaria, it makes people susceptible Vibrio cholera (Harris et al., 2005). Therefore, this interplay between the different diseases on ABO blood type (e.g., cholera vs. malaria) could contribute to the phenomenon of a balanced polymorphism in the human population genetic structure (Hamilton, 2009). In a nut shell, the current study established that among the various ABO and Rh blood groups, blood group O is the most common, followed by blood groups A, B, and AB with a predominance of Rh positivity. This work will East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 9 provide useful information for health institutions in the establishment of regional and national programs that speed up blood transfusions and tissue transplants needed in clinical practice. Additionally, this work is expected to generate interest in population geneticists and anthropologists to study genetic variation at ABO and Rh loci, as well as for physicians interested in the application of immunogenetics in diagnosis and clinical practice. Acknowledgements The authors would like to thank all the participants for their cooperation and Hawassa University for giving ethical permission to conduct the research and for financial support. References Abdelmonem M., Fyala A., Boraik A., Shedid M., Mohamed A.H. and Abdel-Rhman M. 2019. Distribution of Blood Types and ABO Gene Frequencies in Egypt. Am. J. Clin. Pathol. 152(1): S153-S153. Anifowoshe A.T., Owolodun O.A., Akinseye K.M., Iyiola O.A. and Oyeyemi B.F. 2017. Gene frequencies of ABO and Rh blood groups in Nigeria: A review. Egypt. J. Med. Hum. Genet. 18(3): 205-210. Anstee D., 2010. The relationship between blood groups and disease. Blood, 115(23): 4635-4643. Canizalez-Román A, Campos-Romero A, Castro-Sánchez J.A., López-Martínez, M.A., Andrade-Muñoz F.J., Cruz-Zamudio C.K.. and Flores-Villaseñor H. 2018. Blood groups distribution and gene diversity of the ABO and Rh (D) loci in the Mexican population. Biomed Res Int ., 2018. Cserti C.M. and Dzik W.H. 2007. The ABO blood group system and Plasmodium falciparum malaria. Blood, 110:2250–8 Dewan G. 2015. Comparative frequency and allelic distribution of ABO and Rh (D) blood groups of major tribal communities of southern Bangladesh with general population and their determinants Egypt J Med Hum Genet, 16(2): 141-147. Fufa A.W. and Debelo D.G. 2019. Distribution of ABO and Rh (D) blood groups among students attending secondary and preparatory schools in Bote town, Oromia national regional state, Ethiopia. Int. J. Sci. Technol. Educ. Res., 10(1): 1-8. Garratty G., Glynn S.A. and McEntire R. 2004. ABO and Rh (D) phenotype frequencies of different racial/ethnic groups in the United States. Transfusion, 44(5): 703-706. Golassa L., Tsegaye A., Erko B. and Mamo H. 2017. High rhesus (Rh (D)) negative frequency and ethnic- group based ABO blood group distribution in Ethiopia. BMC Res Notes, 10(1): 1-5. Hamilton M. 2009. Population genetics. John Wiley and Sons. Harris J.B., Khan A.I., LaRocque R.C., Dorer D.J., Chowdhury F., Faruque A.S. and Calderwood S.B. 2005. Blood group, immunity, and risk of infection with Vibrio cholerae in an area of endemicity. Infect. Immun. 73(11): 7422-7427. Jing W., Zhao S., Liu J. and Liu M. 2020. ABO blood groups and hepatitis B virus infection: a systematic review and meta-analysis. BMJ open, 10(1). Liu J., Zhang S., Wang Q., Shen H., Zhang Y. and Liu M. 2017. Frequencies and ethnic distribution of ABO and RhD blood groups in China: a population- based cross-sectional study. BMJ open, 7(12): e018476. Ndoula S.T., Noubiap J.J.N., Nansseu J.R.N., and Wonkam A. 2014. Phenotypic and allelic distribution of the ABO and R hesus (D) blood groups in the Cameroonian population. Int J Immunogenet ., 41(3): 206-210. Nei M. 1973. Analysis of gene diversity in subdivided populations. Proc. Nat. Acad. Sci., 70(12), 3321- 3323. Pagani L., Kivisild T., Tarekegn A., Ekong R., Plaster C., Romero I.G., Ayub Q., Mehdi S.Q., Thomas M.G., Luiselli D. and Bekele E. 2012. Ethiopian genetic diversity reveals linguistic stratification and complex influences on the Ethiopian gene pool. Am J Hum Genet . 13;91(1):83-96. Pagani L., Schiffels S., Gurdasani D., Danecek P., Scally A., Chen Y., Xue Y., Haber M., Ekong R., Oljira T. and Mekonnen E. 2015. Tracing the route of modern humans out of Africa by using 225 human genome sequences from Ethiopians and Egyptians. Am J Hum Genet. 96(6):986-91. Panda A.K., Panda S.K., Sahu A.N., Tripathy R., Ravindran B. and Das B.K. 2011. Association of ABO blood group with severe falciparum malaria in adults: case control study and meta-analysis. Malar J, 10(1): 309. Puryear D., 2017. The Right Type of Diet: A Thesis on the potential relations between your blood type and the way you eat. Rowe JA, Opi DH, and Williams TN., 2009. Blood groups and malaria: fresh insights into pathogenesis East Afr. J. Biophys. Comput. Sci. (2022), Vol. 3, No. 2, 1-10 10 and identification of targets for intervention. Curr Opin Hematol . 16(6): 480 Tekeste Z, and Petros B., 2010. The ABO blood group and Plasmodium falciparum malaria in Awash, Metehara and Ziway areas, Ethiopia. Malar J, 9(1):280. Tesfaye K, Petros Y, and Andargie M., 2015. Frequency distribution of ABO and Rh (D) blood group alleles in Silte Zone, Ethiopia. Egypt J Med Hum Genet 16(1):71-76. Zhao J, Yang Y, Huang H, Li D, Gu D, Lu X, Zhang Z, Liu L, Liu T, Liu Y, He Y., 2021 Relationship between the ABO blood group and the coronavirus disease 2019 (COVID-19) susceptibility. Clin Infect Dis. 73(2):328-31. .