Background: Malaria is a disease transmitted by vectors and caused by unicellular Plasmodium parasites. Malaria pathogenesis is associated with the ABO phenotype. However, there is little information on the frequency of malaria disease and its relationship with the ABO blood group in the study area. Therefore, the purpose of this study was to determine the prevalence of malaria infection and its association with the ABO blood group at Woldia Comprehensive Specialized Hospital.Method: An institutional‐based cross‐sectional study was conducted from December 3, 2022, to February 30, 2023. Convenient sampling was used for selecting the study participants. To identify malaria parasites, thick and thin blood films were made. Additionally, blood was drawn to identify the ABO blood group type. Before being analyzed with SPSS software Version 27, the data was coded and entered into EpiData Version 3.1. To ascertain the variable’s association, a logistic regression was done.Results: Out of 192 patients that attended Woldia Comprehensive Specialized Hospital, 16 (8.3%) were found to be infected with Plasmodium parasites using microscopy. Among them, 9 (4.7%), 5 (2.6%), and 2 (1.0%) had Plasmodium falciparum, Plasmodium vivax, or mixed infections, respectively. As a result, 30.7%, 25.5%, 24.5%, and 19.3% of the participants had blood types A, B, AB, and O, respectively (AOR = 2.359, 95% CI: 1.03–12.289, p = 0.03).Conclusion and Recommendation: The total number of microscopically confirmed malaria parasites was 8.3%. P. falciparum was dominant over P. vivax. Individuals with blood group O were less likely to get severe malaria than those with other blood groups. Based on the findings of this study, we recommend that additional studies investigate the probable relationship between the ABO blood group phenotype and malaria infection.

Malaria is a significant public health concern, particularly in endemic regions. Asymptomatic blood donors pose a risk for transfusion-transmitted malaria,

Malaria immunity is complex, being species and stage-specific, and requires both innate and adaptive immune responses to protect against a blood-stage Plasmodium parasite. Repeated infections are necessary to generate and maintain clinically protective immune responses throughout a person's lifetime. While repeated natural infections with Plasmodium sp. parasites induce protection from severe disease, they do not confer sterile immunity, making immunity to Plasmodium incomplete. The development of a malaria vaccine is crucial to prevent infection, reduce disease/parasite burden, or prevent the spread of infection from existing hosts, depending on the stage of the malaria parasite life cycle to be targeted. Merozoite surface protein-1 (MSP-1) and merozoite surface protein-2 (MSP-2) are two proteins that pose a challenge to the human immune system and are important candidates for blood-stage malaria vaccine production. Antibodies to MSP-1 can inhibit parasite growth in vitro and have been associated with protection against malaria in several epidemiological studies. MSP-1 elicits not only neutralizing but also opsonizing antibodies against Plasmodium falciparum blood-stage parasites. The induction of opsonizing antibodies might be a crucial effector mechanism for MSP-1-based malaria vaccines. Evidence has shown that antiparasite immune responses can efficiently control malaria parasite infection at all stages, and the induction of host immune responses targeting all stages of the parasite is critical for the development of an effective vaccine. Overall, the immune response to malaria is a dynamic and multifaceted process, and ongoing research is focused on harnessing this knowledge to develop an effective malaria vaccine.