indian presentation template

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Get Free Indian Google Slides Themes and Templates

Religion In India

Religion in India is one of the most diverse and complex in the world, with a range of beliefs and practices.  This free presentation template with patterns is an excellent tool for exploring the rich complexity of India's traditions. This template features a wide range of design elements, including patterns, icons, and text placeholders, that can be customized to fit any presentation need.

Red Bright Indian Presentation

Do you want to prepare a unique, beautiful, and unusual presentation about India, the oldest culture in the world? Use our free Red Bright Indian Presentation template to get your free design and start customizing. Template customization is available in Google Slides and other presentation editors. Save your time and money with LoveSlides designs!

Bright Colorful India

Indian culture is considered one of the oldest in the world! Do you want to make not just an interesting, but also an attractive presentation on this topic? We have created a Bright Colorful India presentation design to make sure you can cope with this task. Add any content, and use ready-made slides or update them for a specific topic.

Colorful Culture India

Share the facts about the impressive and ancient culture of India with our stunning, colorful, and eye-catching Colorful Culture India presentation template. You can use already prepared slides from professional designers for free and save a lot of time! You can work on customization in Google Slides.

Yellow Indian Culture

Do you want to make an interesting and enticing report about one of the oldest cultures in the world? Then we offer you to use our handy Yellow Indian Culture presentation template. You can use ready-made slides and presentation ideas to save time. You can customize the template both in Google Slides and in any convenient application!

Purple Culture Indian

India is a country with one of the most ancient and great cultures. If you want to share knowledge about this country and its culture with your colleagues or classmates, there is no better option than our free and easy-to-use Purple Culture Indian template. Completely ready-made design and structure of the presentation in purple tones will save you time in creating a presentation.

Colorful Indian Culture

Do you want to tell your audience about the exciting Indian culture? Our template has a bright style which perfectly reflects the special things this country is famous for. We also added images of Indian people which makes the presentation more interesting. Every slide you show will amaze everyone in the hall. You can use all the slides we prepared for you or only some of them. All you need to do to start using this template is to make a copy of it and open it in Google Slides.

Magenta Indian Culture

Indian culture is something totally special. Many people have heard some interesting facts about it but they do not have a full picture of life in India. Your presentation about it will help them to understand this culture deeper. We did our best to make these slides suitable for presenting Indian culture. You can add your own images and text to the template, change font style and make any other changes in Google Docs right this moment.

It is very challenging to make a presentation that will attract all listeners to the problem, make your marketing campaign better, or help you understand the intricacies of the development of Asian culture? Creating a truly professional presentation can take a huge amount of effort and time. Not everyone knows how to manage the functionality of the editors needed for this, and many still don’t want to spend just a huge amount of time and energy on this process. If you belong to at least one of the above categories, then we recommend using our completely free presentation for Indian culture templates.

Our team knows how important it is to tell about your roots and not forget your ancestors. That is why we have launched a new category on our website. Here you will find more than four hundred templates on different topics and a presentation about Indian culture is no exception! No more wasting your time or money. Everything will be done by professionals, and you will only have to add relevant content to a ready-made, fully designed, and structured template to complete your presentation.

How do you like our amazing offer? We invite you to check the benefits available to our visitors around the world!

Benefits of Our Options

Hundreds of people visit our website every day looking for presentation templates on various topics. And we are happy to invite you to join these satisfied guests! To do this, you do not need to do anything, just select the right template and start!

Most Transparent Service

We offer to use our Indian culture slides for free. Moreover, for this, you do not have to register on the site, spend time buying a shareware subscription, and so on. We're not trying to monetize your time or have you buy a free subscription and forget to cancel. The main thing for us is development. Therefore, we offer only the best templates and the most convenient service, so that you are as satisfied as possible with your choice.

If you want to help our platform development, we will be very grateful. Just subscribe to us on social media, or leave a link to our resource in your presentation. This way we will get more clients and you will get more of the best presentation templates!

Only the Best Presentation Designs

We cooperate with professional designers who have been working in this industry for more than a year know how and can create amazing designs and much more. To achieve such mastery, you need to constantly monitor current trends and have vast experience and skills in working with any editor. Thus, we can guarantee that any presentation on Indian culture and tradition based on our template will be the best option for a school project, business, and other needs.

Convenient Customization in Any Format

We suggest you pick a convenient editor for working with our templates. To proceed with customization, you just need to click the yellow Edit a Google Slides Theme button. You will immediately be redirected to the desired page of this platform and receive a copy of the template you like. Right after that, you can use Google Slides for customization.

If you want to work in another offline application, then just download the Indian culture theme for Google Slides on your computer and open it in the desired application.

We are confident that our template ideas will help you create an amazing presentation!

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Flag of India Template for PowerPoint and Google Slides

Google Slides , POTX

India Editable PowerPoint Map

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Bangladesh Flag PowerPoint Template

India Flag PowerPoint Template

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We present a select collection of Google Slides themes and PowerPoint templates inspired by India, capturing the magic and cultural diversity in unique designs. Each piece has been designed in detail, reflecting the rich mix of traditions and landscapes that characterize India. From the majesty of the Taj Mahal to the vibrant festivals that fill the streets with color, each template offers a glimpse into the vibrant and complex identity of the subcontinent.

Explore the adaptability of our India PowerPoint templates and Google Slides themes. Ideal for presenting business information or telling stories of its rich history, these modern resources are the ideal backdrop for your ideas. Highlight the visual beauty of India and use these digital assets to turn your presentations into immersive narratives that capture the true essence of this fascinating nation.

Free India Templates for PowerPoint and Google Slides

India Tourism Template

Indian Independence Template

Indian Customs Template

Indian Gastronomy Template

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India PowerPoint Format

• Product ID : SM-14180
• Subject : India
• Quantity : 40 slides
• Ratio : 16:9
• Format : MS Powerpoint
• Colors : yellow purple
• Languages : EN
• Used Font : Pacifico, Calibri
• License : Personal and commercial use
• Rating : Basic, Premium
• K Keynote version : go to item chevron_right
• G Google Slides version : go to item chevron_right

Slide Description

• Creative slides
• All elements are editable
• Quick and easy to customize
• Data charts (editable via Excel)
• Shapes: fully editable vector graphics
• 16:9 aspect ratio

Table of Contents

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Free India Map Presentation Templates

Turn your india presentation into a vibrant adventure with beautiful free india map powerpoint templates and google slides themes highlight states, showcase landmarks, and tell your story with colorful maps, stunning visuals, and easy-to-edit slides. from heritage wonders to tourist hotspots, captivate your audience. start exploring for free today.

• Colorful maps of India: Highlight states, cities, or regions and mark key locations with pinpoint accuracy and visual flair. Choose from detailed outlines to simplified versions, all ready to be customized to your needs.
• Thematic slides: Dive deep into specific aspects of India, from its mesmerizing dances to its ancient heritage sites. Find slides showcasing airways, tourist hotspots, demographic data, or even India's location on a world map.
• Effortless editing: No more wrestling with complex software. Our templates are 100% editable, allowing you to personalize colors, fonts, and content with just a few clicks.
• Variety at your fingertips: Choose from multiple formats (4:3 and 16:9) and orientations (portrait and landscape) to perfectly match your presentation platform and style.
• Free slides to start your journey: Explore our selection of free templates to find the possibilities to use our slides.
• Royalty-free: Use and reuse our templates without any copyright hassles.
• Professional quality: Deliver polished presentations that impress your audience.
• Easy to use: No design skills required, just drag, drop, and customize.
• Time-saving: Focus on your content, and let us handle the visuals.
• Affordable: Choose from a range of paid and free options to fit your budget.

We're here to help you!

What kind of india maps are included.

We offer detailed, editable maps with states, regions, key locations, and even maps showing India on the world stage!

Do these templates work with PowerPoint and Google Slides?

All our templates come in formats compatible with both platforms, so you can choose your preference.

Are these templates free to use?

We have a selection of stunning free India map slides to get you started.

Can I customize the maps and other elements?

Every element is 100% editable. Change colors, add text, swap icons, and make the slides your unique creation.

Do you have any tips for creating a great India presentation?

Use impactful visuals, highlight interesting facts, and tell a compelling story about this incredible land. Remember, keep it engaging, and let your passion shine through!

Can I download the templates right away?

Yes! Simply browse our "India Map Presentation Templates" category and start downloading your favorites. It's quick and easy!

Do you offer any support if I have questions?

We're happy to help! Contact our friendly team if you have any questions about using our templates or creating your India presentation.

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Incredible India Presentation - Free Download

(10 Editable Slides)

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Digital India Presentation Theme - Free Download

The ‘Incredible India’ initiative is an initiative to promote the country's tourism and breathtaking landscapes. This multifaceted campaign aims to establish India as a vibrant tourist destination, showcasing its historical monuments, scenic beauty, and dynamic cultural tapestry. The initiative also focuses on attracting global travelers and nurturing a stronger appreciation for the country’s unparalleled allure, boosting economic growth and cultural exchange.

Download our Incredible India Presentation Theme for PowerPoint and Google Slides to showcase more details about this campaign and India’s diversity in a visually engaging manner. The gradient background, paired with visuals of Indian cuisine, forts, and more, gives this deck a creative edge. Harness these design elements of this template to elevate your presentation and leave a lasting impression on your viewers!

The PPT’s Overview

• Kickstart your presentation with the eye-catching cover slide.
• Showcase your presentation’s key topics using the Table of Contents slide.
• An overview of the campaign is presented through an aesthetic design.
• The cultural heritage of the country is shown with clarity.
• One of the slides depicts India’s architectural marvels.
• The natural beauty of the nation is illustrated via a stunning illustration.
• An illustration of various food dishes represents the famous cuisine across India.
• The adventure tourism spots are highlighted using an eye-pleasing infographic.
• The popular destinations and places around the country are demonstrated through a compelling illustration.
• A ‘Thank You’ slide is provided to help you express gratitude for the audience’s unwavering attention throughout the presentation.
• Easy customization
• High-quality graphics
• Copyright-free
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MyFreeSlides

India Google Slides and Powerpoint Template

India google slides themes and powerpoint template.

This Trendy Country PowerPoint Template is a nice and captivating presentation for multipurpose uses, you are free to use for school, colleges, corporal meeting presentations. Also, can be used by teachers, businessman, employees, startups to show professional look in their presentation. You can use it to present the Nation’s demographical, cultural and geographical topics along with their Flags icons which can be used as various Powerpoint Presentations.

You can make patriotic slides to exhibit citizenship behavior for your country and determination to give life to your country.

Companies or startups can also easily use these Free google slides themes to market, Report and demonstrate their new product’s launch and the services they provide in a specific country or their growth in international markets. This Powerpoint template can also be used to create projects of school, colleges on History, Geography or report on the country.

The Free India Powerpoint template features:

1. Intro and History slide : Start your presentation by adding the introduction about the country, it’s history and evolution that is how are the people evolve in the country their tradition, culture, religion, dressing sense, etc. Add an image to enhance the quality of your presentation. 2. Famous Personalities : Include the names of some of the famous persons, explorers, reformers, noble people, democrats, elite members, etc. 3. Geography and Climate : Add points regarding the climatic conditions, geographical locations – latitudes & longitudes, etc. You can always use various Icons and shapes to make a presentation more interactive. 4. Government and policies : This free learning presentation can be used to include the running political party and its policies. Also, add few points regarding the economy and expenditure on different fields of the country that is education, sports, poverty, cleanliness, and environment, welfare for people, scientific research and technological improvement, defense and military, etc. 5. Extras : Powerpoint world map template slide to show the location, fun facts about the country, medical improvements, demographic slides, about (add population, capital, city details etc), Quotation slide, Title slide, etc.

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Indian Presentation Template

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Indian Presentation Template Special Features

Make your next PowerPoint, Google Slides, or Keynote presentation more effective with our professionally designed Indian template. Improve the way you present seminars, webinars and lectures. Make more exciting sales presentations, trade show displays and product promotions, or use them in any educational setting for more impact and greater retention.

Indian presentation template includes built-in layouts and stunning backgrounds to make your presentation a winner. The attention we pay to the finest detail make this presentation template truly world-class.

We take pride in employing features most companies skip because it's "too much work." This Indian presentation theme is carefully considered and implemented to maximize the beauty, consistency, clarity and -- most importantly -- audience impact of your presentation.

Intuitive and Easy To Use

Enhanced colors, stunning imagery, professional typography, make life easy, 17 professional pre-made slides, make life even easier.

All our presentation templates are saved in POT, PPT, and PPTX formats to make them compatible with your presentation software like Office for Mac, Keynote, Google Docs, OpenOffice, and others. Some MS PowerPoint features may not be supported by your presentation software. Please read more about Microsoft PowerPoint compatibility in your software documentation.

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Indian Heritage PowerPoint Templates & Google Slides Themes

Unlock your presentation potential: explore our collection of professionally crafted free and premium powerpoint templates and backgrounds for instant download.

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• Indian culture

Native American Heritage Month Free Presentation Template

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Choose and download Indian Heritage PowerPoint templates , and Indian Heritage PowerPoint Backgrounds in just a few minutes. And with amazing ease of use, you can transform your "sleep-inducing" PowerPoint presentation into an aggressive, energetic, jaw-dropping presentation in nearly no time at all. These from free or premium Indian Heritage PowerPoint Templates and Backgrounds are a great choice for a wide variety of presentation needs.

Our Free and Premium PowerPoint Templates are "pre-made" presentation shells. All graphics, typefaces, and colors have been created and are pre-set by an expert graphic designer. You simply insert your text. That's it!

Free vs. Premium Indian Heritage PowerPoint Presentation Templates

PoweredTemplate offers a wide range of free Indian Heritage PowerPoint Presentation Templates. You can find them by filtering by “Free”, from the “Filters” option on the site, on the top left corner of the screen after you search. This content is completely free of charge.

If you download our free Indian Heritage PowerPoint templates as a free user, remember that you need to credit the author by including a credits slide or add an attribution line “Designed by PoweredTemplate”, clearly and visibly, somewhere in your final presentation.

PoweredTemplate also offers premium PowerPoint templates, which are available only to Premium users. There is no difference in product quality between free and premium Indian Heritage PowerPoint Presentation Templates.

Best Indian Heritage PowerPoint Templates

Are you looking for professionally designed, pre-formatted Indian Heritage PowerPoint templates so you can quickly create presentations? You've come to the right place - PoweredTemplate has created these templates with professionals in mind. At PoweredTemplates, we understand how busy you are and how you love to save time.

That's why we've created a set of PowerPoint design templates with an Indian Heritage theme. These Indian Heritage PowerPoint templates are a great choice for a wide variety of presentation needs. Spend your time wisely - download the Indian Heritage PowerPoint Templates today.

Indian Heritage PowerPoint Presentation Themes FAQ

What are indian heritage powerpoint templates.

A PowerPoint template is a pattern or blueprint for your slides that you save as a .pptx or .potx file.

All the Indian Heritage PowerPoint templates are natively built in PowerPoint, using placeholders on the slide master, color palettes, and other features in PowerPoint, and can contain layouts, theme colors, theme fonts, theme effects, background styles, and even content (according to Microsoft Office).

How to choose Indian Heritage PowerPoint templates for presentations?

Choose after carefully studying the template features and viewing the big preview images. All the product information is on the product page in the description and a list of the features can be found in the horizontal scrolling bar under the Download button. You may download a few free templates before making the final decision.

Who are Indian Heritage PowerPoint templates suitable for?

Why do i need indian heritage powerpoint templates.

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Indian Food Dishes Ppt PowerPoint Presentation Complete Deck With Slides

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BCG presentation examples: 40+ downloadable presentations 

Learn how BCG consultants create presentations with 40+ real BCG presentations

Co-founder, CEO

Boston Consulting Group (BCG) is one of the three most reputable consulting firms in the world, along with McKinsey and Bain. In the world of consulting presentations, BCG’s slide decks stand out for their clarity, persuasiveness, and compelling graphics.

While most BCG presentations are confidential, some have become public over the years to give us a glimpse into how the consulting giant structures its decks. Below, we’ve collected over 40 BCG presentations that you can view and download. 

We will also walk you through the strategies BCG uses to make its slide decks so compelling, and show you a quick way to create a BCG-style presentation yourself using AI.

17 BCG industry and market analysis presentations examples

In these examples, you’ll see how BCG analyzes markets and industries for its clients. These presentations were created for large organizations to learn about new market opportunities, forecast future developments, and list industry-specific best practices. 

1. Projecting US Mail Volumes to 2020 (2010)

2. Study on enhancing the competitiveness of the iron and steel industry in Malaysia: Final report (2012)

3. Evaluating NYC media sector development and setting the stage for future growth: Final Report (2012)

4. The Media and Entertainment Industry in NYC: Trends and Recommendations for the Future (2015)

5. Sprinting to Value in Industry 4.0: Perspectives from and Implications for U.S. Manufacturers (2016)

6. Smart Cities – how to master the world's biggest growth challenge (2014)

7. The Electric Car Tipping Point (2017)

8. Decoding the digital opportunity in retail (2017)

9. Shifting Trade Rules and the Future of North America's Auto Industry (2018)

10. Global Challengers 2018: Digital LeapfrogsResearch Highlights (2018)

11. Russian Consumers and the New Economic Reality: Russian Consumer Sentiment 2018 (2018)

12. The Great Mobility Tech RaceWinning the battle for future profits (2018)

13. Digital consumer spending in India: A $100 Bn opportunity (Google collaboration) (2018)

14. Decoding the Chinese Internet 2.0: Get Ready for the Next Chapter (2017)

15. Seven Forces Reshaping Enterprise Software (2019)

16. COVID-19 - Urban Mobility Is Evolving in Unexpected Ways (2020)  

17. What’s Chipping Away at Automotive Production (2021)

6 BCG strategic and policy recommendations presentations examples

BCG created these presentations to highlight strategic and socio-economic challenges faced by various governments and policy organizations . Flip through these examples, and you’ll see how BCG walks its audiences through different policy issues, their implications, and proposed solutions.

18. Loose dogs in Dallas: Strategic Recommendations to Improve Public Safety and Animal Welfare Presentation of findings to City Council (2016)

19. Reshaping NYCHA support functions - BCG Engagement: key findings and recommendations (2012)

20. The end of management as we know it? Could agile can be an antidote to this existential crisis? (2019)

21. Retail Banking in the New Reality (2020)

22. COVID-19 Therapies and Vaccines (2020)

23. BCG Telco Sustainability Index 2020 (2021)

7 BCG client engagement presentations examples

These client engagement presentations shine a light on BCG’s methodology for delivering tailored solutions for its clients’ needs . In these examples, you will see how BCG guides clients to data-driven decisions with slides that clearly show the results of meticulous research and analysis.

24. San Pedro Bay Clean Truck Program: CTP options analysis (2008)

25. Value guided healthcare as a platform for industrial development in Sweden — feasibility study: Conference presentation (2009)

26. Value guided healthcare as a platform for industrial development in Sweden — feasibility study: Final Documentation (2009)

27. The Open Education Resources ecosystem: An evaluation of the OER movement’s current state and its progress toward mainstream adoption (2013)

28. Unlocking the growth opportunity of the 'Responsible Consumer' Unilever work session (2015)

29. Corporate Ventures in Sweden: How to improve the connection between Swedish start-ups and corporations? (2016)

30. Melbourne as a Global Cultural DestinationFinal Report (Summary) (2017)

13 BCG thought leadership and research presentations examples

These presentation examples show you how BCG assumes the role of thought leader in tackling major, complex topics that affect the world. Here, the consulting firm presents some of its most innovative ideas and drives the public discourse around them. 

31. The Innovation Bottom Line: How Sustainability is Paying Off (2013)

32. Bringing innovation to the front-lineVector Control market features and incentives for innovation (2017)

33. True-Luxury Global Consumer Insight (2015)

34. The True-Luxury Global Consumer Insight (2017)

35. Understanding the path to digital marketing maturity - Digital Marketing Maturity studyAustralia & New Zealand (2018)

36. The Bionic Future (2019)

37. US CPG Growth Leaders: Who they are and why they win (2020)

38. Global Restart: Key Dynamics COVID-19 BCG Perspectives Series (2020)

39. The Economic Impact of Ford and the F-Series (2020)

40. The Race for Innovation Executive Perspectives (2021)

41. IT Services - The Rates of Success, Goals, and Future Priorities of Digital Transformations, by Sector (2022)

42. BCG Investor Perspectives Series Pulse Check #21 (2022)

43. The Future of Sales and Marketing Is Here Executive Perspectives (2022)

Why BCG presentations are so effective

BCG presentations are effective at delivering information and persuading their audiences because of these four principles used in deck creation:  

• The Pyramid Principle 
• The SCQA framework 

Color coding

• Quantitative research 

Let’s take a more in-depth look at these four strategies below. 

The Pyramid Principle

Much like McKinsey presentations , BCG slides make heavy use of the Pyramid Principle in building its presentations . This principle gets its name from the way information flows in a presentation. It starts with the main point or idea — think of this as the pointy top of a pyramid. Next, BCG breaks this idea out into several key arguments; this is where the pyramid gets wides going from top to bottom. Finally, each of the arguments gets rooted in various pieces of evidence, shaping the pyramid’s widest, bottom portion. This evidence comes from exhaustive research BCG performs when preparing the slide content; for added credibility, the consultants show all the sources for the evidence that backs up each slide’s principal idea. 

BCG presentations start with an executive summary of the key information and provide supporting slides with increasing amounts of detail to make their key points. It’s particularly effective for delivering large quantities of information, as the viewers can easily understand how every argument and bit of evidence relates to the main topic. This approach informs, persuades, eliminates ambiguity, and keeps the spectators’ attention.

Situation, Complication, Question, Answer (SCQA) framework

One useful strategy when preparing a presentation outline is structuring the information you deliver in a story-like format. BCG understands the importance of the story format and makes use of the SCQA mechanism. Here’s how each of the SCQA components help shape the storyline in a consulting presentation: 

• Situation (S): The Situation is the first element of the “story.” It provides an overall context for the viewers. Here’s an example of a statement that summarizes the “Situation” in the SCQA model: “Company X has been a leader in the electric vehicle industry for the last decade, with a strong presence in markets around the world.” 
• Complication (C): The Complication is the second component of the narrative arc — arguably the equivalent of “conflict” in literature. It tells the presentation viewers how the situation has changed (or is changing), and lists the effects of this shift. For example, “Despite its successes, Company X’s position as the industry leader has slowly eroded due to market saturation and new players from emerging economies offering more innovative and economical electric vehicles.”
• Question (Q): The Question part of the framework gets the audience thinking whether the issue at the center of the presentation can be addressed or remediated. For example, one of the questions pertaining to our example above could be “Can Company X regain its edge in the industry in a market saturated with low-cost competitors?”
• Answer (A): The Answer element then presents the audience with a response that outlines one or several solutions to the complication. For example, “Yes, company X can regain its foothold as the market leader by investing in research and development while coming up with a more competitive pricing strategy.”

BCG also has a simple yet powerful way of using color to highlight key takeaways in its slides. While most BCG slide decks feature the same white and green theme, you’ll notice that some slide elements are colored differently. This visual contrast immediately catches the viewers’ eyes , so they waste no time in finding the key takeaways on each slide. 

Heavy use of graphics 

While BCG presentations are often info-dense with slide content, they generally feature more graphics than their McKinsey peers. BCG consultants like to use data to tell stories, and some BCG decks — like this one on the implications of bionic technology — rely almost exclusively on charts, graphs, tables, and images to educate the audience.

Quantitative research to prove subjective points

Apart from color coding, graphics, a slide structure that follows the Pyramid Principle and SCQA principles, BCG presentations also lean heavily on survey results to back up their claims. This tactic lets the consultants reinforce points that may be construed as subjective with quantitative research. This technique contributes to BCG presentations’ one-of-a-kind ability to help clients make data-driven decisions.

A look at the typical BCG presentation and slide structure

BCG presentations can vary widely in the topics they cover, but their structure generally goes like this: 

• Minimalist title page summarizing the presentation topic
• An executive summary overviews the key points that will be addressed in the body slides 
• Agenda pages separate different sections of the presentation
• Graphic-rich body slides help BCG make establish its case
• The conclusion outlines BCG’s solutions in content-packed slides

Below is a more detailed look at each of these structural elements.

Minimalist title page summarizing the presentation

BCG’s slide deck front pages are less info-rich than their McKinsey counterparts. Where McKinsey’s front pages usually disclose or foreshadow some of the info that gets revealed further in the deck, BCG’s title slides generally contain nothing more than a clear, unambiguous presentation title .

Executive summary after the title slide

Most BCG presentations include a thorough executive summary soon after the front page . This section provides a succinct summary of the information that will appear in the slides that follow. In fact, BCG consultants are trained to write slides and summaries that allow someone to understand a presentation by only reading the titles of each slide.

For particularly long presentations that span several distinct parts (like this example on the competitiveness of the Malaysian iron and steel industries), BCG usually includes an executive summary for each part.

Agenda page

In lengthy presentations that are split into several parts, BCG usually prefaces each part with an agenda page . This page shows the current section in relation to the complete outline of the slide deck, so the viewers can keep track of the presentation’s progress. 

Body slides structured using the Pyramid Principle and effective color coding 

The body slides of BCG presentations follow the top-down Pyramid Principle . At the top of each slide is an “action title” that explains the key takeaway for each slide. Some slides have a subtitle that provides additional context, while others dive right into the supporting arguments and evidence, along with research sources. 

The body slides are generally packed with graphics, and rely on color coding to highlight the most essential bits of information . For example, below you can see how BCG deviates from its green color theme with the use of yellow. In both stacked bar charts, yellow represents data points that support the arguments “Very few countries worldwide without domestic long steel” and “Long steel is a basic need”. BCG uses the yellow here to draw your attention to these data points because they reinforce the arguments, which, in turn, serve as the foundation of the statement made in the slide title.  

Conclusion contains a roadmap for implementation of BCG’s proposed solutions

Like many management consulting presentations, BCG’s presentations typically end with thorough conclusions that discuss solutions to problems . These solutions are often presented with very detailed implementation strategies. Sometimes, these closing slides will depart from the graphic-dense format of the presentation’s body, and focus on written content. 

Nonetheless, BCG structures these slides in the same top-down fashion that allows for clear and easy flow of information. 

Build a BCG-style slide deck yourself quickly using AI

Whether you’re a novice or experienced presentation creator, it will take time to perfect the art of creating BCG-style slide decks. By harnessing the power of AI, you can make the process a bit faster. 

While no AI presentation makers can generate a deck of the same quality as BCG makes for its clients, a quality AI slide creator like Plus AI can take some of the heavy lifting off your hands by auto-generating slide content . Whether you’re armed with nothing but an idea, or have extensive research compiled, you can feed what information you have to the AI slide maker and it will turn it into well-flowing slide content once it generates the slide deck. This way, you have an excellent starting point from which to fine-tune the presentation.

Also, Plus AI’s slide decks are perfectly formatted, so you don’t need to worry about ensuring the consistency of fonts, margins, and other elements. 

How to create a BCG-style consulting deck with Plus AI 

Follow these simple steps to build a BCG-inspired consulting deck with Plus AI: 

• Open Google Slides or PowerPoint, then launch the Plus AI extension and click on “New presentation”. 

• Choose one of three prompting methods. “ Use a prompt ” lets you quickly start from scratch if you don’t have any materials for the presentation yet — just tell Plus AI what the presentation is about, and it will get to work making the deck. On the other hand,  “ Upload a file ” and “Slide by slide” methods are more suitable if you have materials on which to base the presentation.  

• Prompt Plus AI. For instance, your presentation is based on WTO’s report about the effects of COVID-19 and trade tensions on global value chains. If you have the report saved on your desktop, you can use the “Upload a File” function to upload the entire document to Plus AI.  

• Find a template you like. 

• Click the “Generate Presentation” button. 

• Edit the slide content. Plus AI will prepare the presentation in a manner of minutes, and you won’t need to waste time on tedious (but otherwise necessary) tasks like formatting. That said, you should edit the auto-generated deck and implement strategies like the Pyramid Principle and SCQA to align it with BCG’s slide design approach. 

Learn more about using AI to create PowerPoint and Google Slides presentations

If you’re intrigued by the idea of making quality consultant presentations quickly with Plus AI, head to our resource library and find out how to use this tool effectively. You’ll learn how to make beautiful slides , prepare decks for a presentation , captivate your audience on the big day , and more.

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Delayed Presentation of Malrotation after Infancy: A Systematic Review Based on Clinical Presentations, Associated Anomalies, Diagnosis, and Management

Sharma, Charu; Borkar, Nitinkumar Bhajandas; Ashwin, C.; Sinha, Chandrasen 1

Department of Paediatric Surgery, AIIMS, Raipur, Chhattisgarh, India

1 Department of Paediatric Surgery, St. George’s University Hospital, London, UK

Address for correspondence: Dr. Nitinkumar Bhajandas Borkar, Department of Paediatric Surgery, AIIMS, Raipur - 492 099, Chhattisgarh, India. E-mail: [email protected]

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Need and Purpose of Review: 

Approximately 75% of patients with classic malrotation and midgut volvulus present in neonatal age-group; another 15% may present up to one year. In these, the diagnosis is made because of typical presentation. However, there are many cases in which malrotation has been detected after infancy. In-spite of the variable case reports and studies in literature, there is no specific data on the incidence of malrotation after infancy, its presentation and management guidelines. With this systematic review, we aim to coalesce these findings from various individual case reports and studies.

Methods Used for Collecting and Analysing Data: 

This systematic review was performed as per the PRISMA (preferred reporting items for systematic review and meta-analyses) guidelines. The authors conducted thorough searches in databases like PubMed/MEDLINE, SCOPUS, Google Scholar and Web of Science for relevant articles. Studies were reviewed for clinical presentation and outcome for malrotation diagnosed beyond infancy.

Main Conclusions: 

Clinical presentation of malrotation after infancy can be acute as well as chronic; acute presentation being common under 2 years of age and chronic symptoms present as age increases. Sudden onset of abdominal pain and bilious vomiting are commonest acute symptoms and intermittent episodes of recurring vague abdominal pain associated with vomiting and diarrhoea are the commonest chronic symptoms. The diagnostic modalities vary from UGI Contrast series to USG with colour Doppler and CECT scan. Management is operative open as well as laparoscopic Ladd’s procedure is being favoured.

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• Open access
• Published: 24 August 2024

ABO and Rhesus blood group variability and their associations with clinical malaria presentations

• Enoch Aninagyei 1 ,
• Pearl Sedinam Agbenowoshie 1 ,
• Praise Mawuena Akpalu 1 ,
• Selina Blefono Asiewe 1 ,
• Regina Yayra Menu 1 ,
• Fred Gbadago 2 &
• Richard Harry Asmah 1  

Malaria Journal volume  23 , Article number:  257 ( 2024 ) Cite this article

222 Accesses

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Plasmodium falciparum infection is associated with the human ABO blood group. However, there is a paucity of data on the role that ABO and Rhesus blood groups play in malaria clinical presentations. Therefore, the objective of this study was to assess the association of human ABO blood groups and the Rhesus blood (Rh) types with the severity of malaria.

This cross-sectional study was carried out at the Suhum Government Hospital in the Eastern region of Ghana. Conveniently, study participants with malaria, diagnosed by microscopy, were selected into the study. Subsequently, their ABO and Rh blood groups were determined (Accucare ABO/Rh monoclonal antibodies, Chennai, India). Malaria severity was assessed using the criteria for assessing severe malarial anaemia published by the World Health Organization. According to the criteria, severe malarial anaemia was classified as having haemoglobin (Hb) < 5 g/dL for children < 12 years and in patients ≥ 12 years, Hb level < 7 g/dL, with parasitaemia > 10,000/µL in both cases. Severe malarial anaemia was also classified as having plasma bilirubin > 50 µmol/L with parasitaemia ≥ 100,000/µL, for all ages. Chi square statistical analysis was used to test the association between the blood groups and the clinical or laboratory findings, while multivariate analysis was performed to identify which blood groups were more vulnerable to develop severe malarial anaemia.

Of the total number of the study participants (n = 328), most of the patients had blood group O Rh positive (35.7%) while few of them had blood group AB Rh negative (2.1%). The types of Rhesus did not associate with malaria. However, compared to blood group O, the odds of developing severe malarial anaemia, in children < 12 years and in patients ≥ 12 years, were 16 times and 17.8 times higher among patients with blood group A, respectively. Furthermore, the odds of having bilirubin level > 50 µmol/L with parasitaemia ≥ 100,000 /µL was 10 times higher among patients with blood groups A and 2.6 times higher in patients with blood group B, compared to blood group O. Finally, in patients with blood group A majority (71.6%) of them developed high temperature (> 37.5 °C) while 43.3% of them vomited and had diarrhoea. However, pallor (group B = 46.2% vs group A = 37.3%), fever (group B = 84.6% vs group A = 79.1%) and nausea (group B = 46.2% vs group A = 25.4%) were more frequent in patients with blood group B than A.

Conclusions

This study found that people with blood groups A and B were severely affected by malaria, with group A being the most vulnerable. It is recommended that blood group assessment be performed for all patients with malaria. Patients found to have blood group A or B must be promptly and efficiently managed to avoid the development of severe malaria anaemia.

Studies conducted elsewhere on patients with malaria have shown that there is an association between malaria and blood groups of an individual [ 1 ]. These studies have indeed shown that people with the blood group O have a selective evolutionary advantage over malaria compared to people with non- O blood groups (A, B and AB) [ 2 ]. The mechanism by which blood group O confers selective resistance to malaria, while individuals with non- O blood groups show selective vulnerability, has been attributed to rosette formation [ 3 ]. Rosetting is a mechanism in which an infected erythrocyte with Plasmodium falciparum adheres to non-infected erythrocytes [ 4 ]. Therefore, in patients with malaria with the non-O blood group, invasion of uninfected red blood cells is enhanced, compared to the other red cell polymorphs. Rosetting may be mediated by a membrane protein, including PfEMP1 [ 5 ], RIFIN and STEVOR [ 3 ], which are expressed on the surface of the infected host cell. Rosettes formed by non-O blood groups are resilient to disruption [ 6 ].

However, there are several unanswered questions and unclear links about the various blood groups contribute to severe anaemia presentations. Furthermore, the role of Rhesus (Rh) types in P. falciparum infection remains unanswered, since available data on this subject are equivocal [ 7 ].

Despite the comparative vulnerability of blood groups A, B and AB to malaria, the association of these blood groups with malaria severity has not yet been fully studied. Plasmodium parasites are known to cause fever in patients with malaria [ 8 ]. However, it was interesting to note that the degree of fever, assessed by measuring body temperature, does not always correlate with Plasmodium parasitaemia. Furthermore, patients with malaria had a different set of clinical signs and symptoms, even with similar parasitaemia [ 9 , 10 ]. Based on the foregoing, it was hypothesized that host genetic variants may influence clinical malaria presentations. To date, it remains unknown whether blood group variability plays a role in the observed differences in similar levels of parasitaemia. This evidence gap merits investigation. Therefore, the study aimed to explore and determine the association of malaria severity with the ABO and Rh blood groups. In this study, the severe malarial anaemia was defined using strict definitions of the World Health Organization (WHO) [ 11 ]. Per these definitions, the estimation of haemoglobin, plasma bilirubin and parasite count are required to assess severe malaria anaemia.

Study design, site, and participant recruitment

This cross-sectional study was done at the Suhum Government Hospital in the Suhum municipality (Latitude: 6.0379101, longitude: -0.4456668) in the Eastern Region of Ghana. Study participants were patients of all ages who had tested positive for malaria, by microscopy. The hospital is located in a malaria endemic district, where malaria is among the top five diseases recorded at the outpatient department in the study hospital. The hospital also serves as referral facility for other health facilities, both public and private. The healthcare professionals manage malaria according to the Ministry of Health guidelines [ 12 ]. Prospective study participants were patients with malaria classified as uncomplicated by the attending medical officer. After prior informed consent, the study participants were recruited. Study participants were selected based on their availability to the researcher.

Inclusion and exclusion criteria

Participants included in the study were individuals infected symptomatically with malaria, caused by P. falciparum , and had consented to participate in the study. Individuals who did not provide written consent, pregnant women and infants, were excluded from the study. Pregnant women are prone to both physiological and pathological anaemia of other aetiology and in infants it was difficult getting the desired volume of blood for the haematological and the bilirubin assays. In addition, patients who had tested for malaria only by rapid test kit were excluded. Furthermore, patients who had other common diseases (HIV and hepatitis B/C) and other red blood cell genetic disorders (sickle cell disease and G6PD deficient) were excluded from the study, because their co-morbidity could affect the outcome of the investigations. Finally, the microscopically detected Plasmodium parasites other than the P. falciparum species were also excluded from this study.

Sample size determination

Using the Cochrane’s formula, n = z 2 p(1–p)/d2, where n is the sample size, z is the confidence level at 95% (standard value of 1.96), d is the margin of error at 5% (standard value of 0.05), a minimum of 296 malaria patients were used, given that the prevalence of malaria in the Eastern region of Ghana among individuals suspected of malaria was 26% [ 13 ].

Collection of blood samples

With the consent of the patient, blood samples were collected by a trained Ghana Health Service phlebotomist. The area to be sampled (the antecubital fossa) was disinfected with 70% ethanol and allowed to air dry. Using a 23-gauge syringe, whole blood (approximately 4 ml) was collected into an EDTA tube and gently mixed. The punctured side was covered with cotton wool and covered with a phlebotomy plaster.

Laboratory diagnosis of malaria and confirmation of causative species

Malaria was diagnosed by microscopy. In doing that, a thick blood film was prepared using approx. 6µL of whole blood. The smear was air dried, stained with 10% Giemsa for 10 min and any parasite thereof was quantified according to WHO protocol [ 14 ]. Quantification was done by counting the number of parasites per at least 200 white blood cells. The number of parasites counted was then divided by the number of white blood cells counted, and the resulting figure was multiplied by 8000 (that is, the estimated total of white blood cells per microlitre of blood) as used elsewhere [ 15 ]. Subsequently, P. falciparum was specified by detecting the histidine-rich protein 2 (Pfhrp2) with CareStart TM rapid diagnostic test kit (Somerset NJ, USA). Pfhrp2 antigens are specific to P. falciparum . The confirmation of species was carried out placing exactly 5 µL of blood in the sample column and four drops of sample buffer placed in the appropriate column. The results were read after 15 min as recommended by the manufacturer.

Blood group and Rhesus factor determinations

Blood group and Rhesus factor typing were performed using Accucare ABO/Rh monoclonal antibodies (Chennai, India). The tile method was used. In summary, approximately 50 µL of antibodies was mixed with approximately 20 µL of whole blood, for about 30 s. After which the reactions were read. Samples with visible agglutinations were considered positive for the respective antigen and vice versa. Blood samples from known blood groups (A Rh D positive, B Rh D positive, and O Rh negative) were used as controls.

Haemoglobin estimation

Haemoglobin estimation was performed using a fully automated haematology analyser (Urit 5160; Guangzhou, China). The haemoglobin concentration was measured using the cyanide-free colorimetric method.

Bilirubin estimation

Bilirubin estimation was performed by using a Biobase Biochemistry analyser (Guangzhou, China) and Elitech reagents obtained locally but manufactured by the Elitech Group (Allées de Dublin, France). Total bilirubin was estimated on the basis of the modified Malloy-Evelyn endpoint method based on the following principle. Sulfanilic acid reacts with sodium nitrite to form diazotized sulfanilic acid. In the presence of accelerator (cetrimide), conjugated and unconjugated bilirubin reacts with diazotized sulfanilic acid to form azobilirubin. The increase in absorbance at 546 nm is proportional to the bilirubin concentration.

Data and statistical analyses

IBM SPSS data analysis software (version 27) was used to analyse the data. The demographic characteristics, clinical, laboratory findings and the various blood groups of study participants were presented as percentages, using the total number of participants as the denominator. Further, the Chi-square test was used to test the association between the laboratory findings, the different blood groups, and the association between the clinical presentations and the various blood groups. However, Fisher’s exact test was used when the frequencies were less than 5. Further multinomial logistic regression analysis was conducted to verify the relationship between the multinomial outcome variable “blood groups and Rhesus types” and haemoglobin, bilirubin and parasite count variables that showed significance during the chi-square analysis. Blood group O was set as the reference for the blood groups for all regressions. The logistic regression analysis allowed for identifying significant predictors and quantifying their effects on the likelihood of a blood group being associated with severe malaria. Statistical significance was established at p < 0.05.

Demographic characteristics of study participants

The study recruited 328 participants, of whom 67.1% were females and the males were 32.9%. The age range of the participants was < 1 and 89 years. The mean age of the participants was 19.4 years and the standard deviation was 20. Most of the participants, 142/328 (43.3%) were between < 1 and 9 years old. Additionally, the majority of the participants 170/328 (51.8%) were under marital age with 68/328 (20.7%) in high school. Other details of the study participants are indicated in Table  1 .

Clinical and laboratory findings of study participants

Most of the study participants (61.9%) enrolled in the study were recruited from the outpatient department of the hospital. Overall, the mean temperature ± standard deviation of the study participants was 37.4 °C ± 0.8. Furthermore, almost 40% of malaria patients recorded temperatures above 37.5 °C (severe hyperthermia). Surprisingly, 35.4% of malaria patients were hypothermic (temperatures below 37 °C). The overall mean level of haemoglobin was 9.5 g/dL ± 2.7. Among the study participants, 31.1% had no anaemia (Hb level > 11.0 g/dL) whereas 18.0%, 29.3% and 21.6% of the patients with malaria were mildly, moderately and severely anaemic, respectively. Using 17 µmol/L as the cut-off point of the normal human bilirubin level, the majority (69.8%) of the participants with malaria had elevated plasma bilirubin. The majority of the participants (53.0%) also had parasitaemia levels between 10,000 and 100,000 parasites/µL of blood. The signs and symptoms of malaria presented by the majority of the participants were fever (78.4%), chills (67.7%), and headache (59.5%). The other details are shown in Table  1 .

Profiling of the ABO and Rhesus blood groups of study participants

A higher proportion of study participants (45.1%) were of blood group O with patients with blood group AB in the minority (10.7%). Furthermore, the majority of study participants 266/328 (81.1%) were Rhesus positive. Finally, in defining ABO / Rh types, most of the study participants (35.7%) were O positive in the blood group and few of them were AB negative (2.1%). The frequencies found in the other blood groups are presented in Table  1 .

Association of laboratory findings with ABO blood groups in patients with malaria

The three laboratory variables used to assess the association between ABO variability and severe malarial anaemia were haemoglobin level, bilirubin level (jaundice), and parasite density (hyperparasitaemia). Analysis of the data revealed that in patients with malaria, anaemia, jaundice, and hyperparasitaemia are associated with the blood group. Significantly, a higher number of malaria patients with blood group O (42.5%) had no anaemia, while mild anaemia was associated with patients with blood group AB. Furthermore, most of the malaria patients with blood group B (37.2%) were moderately anaemic while those with blood group A (32.8%) were severely anaemic. Furthermore, hyperbilirubinaemia was significantly higher in patients with malaria with blood group A (85.1%, p = 0.001). The Rh types did not associate with anaemia or jaundice, except for Rh positive that associated with hyperparasitaemia (17.4%, p = 0.036) (Table  2 ).

Association of clinical presentations to ABO blood groups in patients with malaria

Table 3 represents the association between the malaria clinical presentations and human blood types. Hyperthermia (> 37.5 °C) was significantly higher in blood group A (71.6%), while hypothermia was common in blood group O (48.6%). It was also observed that Rhesus types did not associate with degree of body temperature. Chills, headaches, fatigue, and muscle ache were not associated with any blood group. However, pallor (46.2%), fever (84.6%) and nausea (46.2%) significantly associated with blood group B, while vomiting (43.3%) and diarrhoea (43.3%) were commonly observed in patients with blood group A. Aside from pallor that associated with Rh positivity (p = 0.015), none of the clinical presentations was associated with any of the Rh types.

Relationship between ABO/Rh groups and severe forms of malaria

The World Health Organization (WHO) has a number of definitions to classify severe malarial anaemia. One of these definitions includes haemoglobin concentration < 5 g/dL together with parasite count > 10,000µL for children < 12 years of age. For patients with malaria ≥ 12 years, the same parasitaemia range together with haemoglobin concentration is < 7 g/dL is diagnostic. In Table  4 , the prevalence of severe malarial anaemia among children classified as having uncomplicated malaria was 8% (26/328). In children, severe malarial anaemia associated with blood group B, while Rh types did not. In patients 12 years or above, the prevalence of severe malarial anaemia among those classified as having uncomplicated malaria was 4.3% (14/328). The incidence of severe malarial anaemia in patients ≥ 12 years associated with blood groups A and B, as well as Rh positivity. Using bilirubin as a criterion, WHO defined severe malarial anaemia as having bilirubin > 50 µmol/L with parasitaemia > 100,000 /µL. With this criteria, 17% (56/328) of the study participants with malaria were severe. Severe malarial anaemia was observed in patients with blood group A whereas Rh types did not associate with severe malarial anaemia (Table  4 ).

Prediction of malaria severity using ABO blood groups

The association of blood groups with the severity of malaria was compared to that of blood group O (reference blood group) (Table  4 ). Compared to blood group O, the odds of blood groups B (aOR = 1.6, 95% CI 0.6–2.7) and AB (aOR = 1.1, 95% CI 0.7–1.9) developing severe malarial anaemia in children under 12 years of age were higher but did not reach a significant level. However, children less than 12 years old with blood group A are approximately 16 times (p = 0.0005) more likely to develop severe malarial anaemia compared to those with the blood group O. For patients ≥ 12 years with malaria, the odds of developing severe malarial anaemia were higher among those with blood groups AB (aOR = 4.4, 95% CI 2.7–6.1, p = 0.0095) and A (aOR = 17.8, 95% CI 12.6–31.2, p = 0.0030), compared to blood group O. Using the bilirubin > 50 µmol/L with parasitaemia ≥ 100,000 /µL criteria, the odds of developing severe malarial anaemia were higher among patients with blood groups A (aOR = 10, 95% CI: 6.5–19.8, p < 0.0001) and B (aOR = 2.6, 95% CI: 1.1–6.0), p = 0.0232), compared to blood group O. However, individuals with the blood groups AB are less likely to develop severe malarial anaemia compared to those with the blood group O.

Variabilities in blood groups play an important role in the pathogenesis of malaria. Several studies have linked malaria to non-O blood group [ 7 , 16 , 17 ]. Among the non-O group, malaria incidence is higher among individuals with blood group B [ 16 , 18 ], some studies have also reported a higher probability of malaria incidence in blood group AB [ 19 , 20 ]. Despite these associations, the impact of ABO and Rhesus (Rh) blood types on the severity of malaria has not been explored, especially in the Ghanaian population.

Among the participants with malaria studied, most of them were blood group O, followed by blood groups B, A and AB. The individuals who were in the O blood group were 54.9%. Among non-O blood groups, individuals with blood group B were more (43.3%), closely followed by blood group B (37.2%). This observation is consistent with previous publications on this subject matter, elsewhere [ 18 , 19 ] and in Ghana [ 21 ]. However, among the general Ghanaian population, blood group O dominates, followed by blood group A, B and blood group AB in the minority [ 22 ].

The association of blood group B or A with malaria is attributable to resetting, which is enhanced in these blood groups compared to blood group O [ 3 ]. Rosette formation allows uninfected red blood cells to be attracted to infected red cells, mediated by the parasite protein called Plasmodium falciparum erythrocyte membrane protein (PfEMP1) [ 23 ]. Hyperparasitaemia was observed to be significantly higher in blood group A compared to the other blood groups. However, it was surprising to observe that low parasitaemia was higher in blood group B compared to blood group O. This observation could be due to the cytoadherence of the parasites in high parasitaemic situations in patients with blood group B, which could reduce the peripheral blood density of the parasites [ 23 , 24 ]. Low parasitaemia after cytoadherence could be the case because even though low parasitaemia was associated with blood group B, more than 30% of them were moderately or severely anaemic, compared to blood group O. Notwithstanding the above, the effect of blood group variations on malaria parasite cytoadherence should be proven in a future study. In contrast, in group A blood, hyperparasitaemia corresponded to the severity of the anaemia, with concomitant hyperbilirubinaemia. Hyperparasitaemia and severe anaemia are linked due to the ability of the parasite to haemolyse infected cells, mediated by enhanced resetting. Hyperbilirunemia is a direct consequence of intravascular haemolysis [ 24 ].

Furthermore, hyperthermia was observed at higher rates in patients with blood group A. This is explained by the associated hyperparasitaemia and severe anaemia. Hyperthermia occurs when infected red cells rupture and uninfected cells are being invaded [ 25 ]. This phenomenon is mediated by cytokines such as tumor necrosis factor (TNF) and interleukins (IL) 2 and IL6 [ 26 ]. Whereas pallor and nausea associated with blood group B of patients with malaria, vomiting, and diarrhoea associated with blood group A. According to the findings of this study, malaria in individuals in blood group A is a medical emergency. This is because the co-occurrence of vomiting and diarrhoea will eventually lead to dehydration, if parenteral fluids are not administered immediately. This will lead to hypovolemic shock and electrolyte imbalance, the result of which is mostly fatal. Due in part to hypoperfusion and hypoxia of the tissue. If left untreated, hypovolemic shock can cause ischemic injury to vital organs, leading to multi-organ failure [ 27 ].

In children, severe malarial anaemia due to low haemoglobin and parasite count > 10,000 per µL was significantly higher in blood group B, while in patients over 12 years of age, severe malarial anaemia was significantly higher in both groups A and B. On the other hand, severe malarial anaemia defined by hyperbilirubinaemia together with parasite count > 100,000 parasites/µL was significantly higher in individuals with blood group A. Therefore, individuals with blood groups A and B are vulnerable to developing severe malarial anaemia compared to blood groups O and AB. For these reasons, blood group assessments should be added to the list of investigations requested for patients suspected of malaria. This will help to promptly and adequately manage individuals who are likely to be severely affected by the disease, to ensure better treatment outcomes.

The majority of the participants studied in this publication were Rh positive (81.1%). However, Rh status was not associated with anaemia, jaundice, temperature, and severity of malaria. Furthermore, none of the clinical presentations associated with Rh status, except pallor. A review by Rattanapan et al. [ 28 ] found an inconsistencies in the vulnerability to severe malaria between individuals with Rh positive and negative. The review analyzed data from 36 eligible papers. Overall, 44.4% of the studies revealed that Rh positive individuals had a lower proportion of malaria than Rh negative individuals, while the remaining studies revealed a higher or no difference in the proportion of malaria between Rh positive and negative. The study then concluded that having Rh positive or Rh negative did not influence the development of severe malaria. This study adds to previous publications that Rh status did not have much impact on malaria clinical presentations.

Even though low levels of haemoglobin, high bilirubin levels with their attendant high parasitaemia were observed in blood groups A and B individuals with malaria, it must be stated that these levels could be confounded by various factors. Low levels of circulating erythropoietin is associated with low red blood cell and haemoglobin counts [ 29 ]. Further, bilirubin levels have also been found to be elevated in liver diseases [ 30 ]. In addition, anti-malaria immunity is likely to influence hyperparasitaemia seen in the study participant [ 31 ]. In addition, other factors such as poor nutrition, lower socioeconomic status and longer duration of symptoms were likely to affect the levels of the biomolecules reported in this study.

Limitations

The study participants were not tested for alpha thalassaemia. The G6PD screening was performed using the sodium nitrite-methylene blue method, which may not be of higher sensitivity, especially at lower haemoglobin levels. Other entero and haemoparasites, such as hookworms, filarial worms, and Babesia parasites, which could affect haemoglobin and bilirubin levels, were not screened. In addition, effect modifiers such as low levels of circulating erythropoietin, liver diseases, incompetent or low anti-malaria immunity, poor nutrition, lower socioeconomic status and longer duration of symptoms could directly or indirectly affect the levels of haemoglobin, bilirubin and/or the parasite counts recorded in this study. Finally, due to the convenient sampling technique employed, the outcome is limited to the population studied.

Out of the 328 participants, severe malarial anaemia was observed in 8% (26/328) children less than 12 years while in patients above 12 years or above, 4.3% (14/328) had severe malaria anaemia. Using hyperbilirubinaemia as a criterion, 17% (56/328) had severe malaria. When these low numbers were distributed among the blood group types, some of the frequencies were very low. However, the odds ratios were determined based on these figures. It was observed that, the odds of developing severe malarial anaemia, in children less than 12 years, was about 16 times higher, in patients with blood group A compared to patients with blood group O, with malaria. For patients ≥ 12 years, the odds of developing severe malarial anaemia was 4.4 times and 17.8 times higher among patients with blood groups A and AB, respectively, compared to patients with blood O. Finally, using the hyperbilirubinaemia with parasitaemia 100,000 /µL criteria, the chances of developing severe malaria were 10 times higher among patients with blood groups A and 2.6 times higher in patients with blood group B, compared to blood group O.

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Acknowledgements

The authors wish to acknowledge the Management of Suhum Government Hospital for allowing samples used for this study to be collected within a short time. Additionally, the role the Medical Laboratory Scientists played in the laboratory analysis merits commendation.

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EA and RHA conceived, supervised and provided resources the study. PSA, PMA and SBA participated in participant recruitment and sample collection. RYM and FG performed laboratory analysis. EA wrote the initial draft. However, all authors approved the manuscript.

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Aninagyei, E., Agbenowoshie, P.S., Akpalu, P.M. et al. ABO and Rhesus blood group variability and their associations with clinical malaria presentations. Malar J 23 , 257 (2024). https://doi.org/10.1186/s12936-024-05081-z

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