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Why are there blood, genotype test results inconsistencies?

ON March 19, 2024, an Ibadan-based baker who gave her name as Nike raised an alarm in a post on X about a change in her genotype after she had conducted a laboratory test.

“All my life I’ve always thought my genotype is ‘A’ because that’s what the result said when I did the test years ago. I did the test again today and the result showed I’m AA. So what happened to the guys I had let go because of genotype?” the post read.

A blood genotype is the genetic makeup of an individual, encompassing all the genes inherited from both parents. It is the complete set of DNA, including all of its genes, which determines specific traits and characteristics. Typically, there are five (5) distinct types of blood genotype namely; AA, AS, AC, SS, and SC

Fatimah Muhammed, a consultant haematologist at Baze University explained that genotype is haemoglobin testing and the common ones in West Africa are: AA, AS, AC, SS and SC, adding there are other variants of haemoglobin in other places such as the Mediterranean.

“The common methods used in genotype testing is the  hb electrophoresis which can be alkaline medium and acidity medium. There are other advanced methods of testing that are used when haemoglobin disorders such as sickle cell anaemia,” Muhammed said.

The importance of knowing one’s blood genotypes is significant as they influence various aspects, such as  physical traits, susceptibility to certain diseases, behavioural tendencies, choosing a life partner and ensuring compatibility in blood transfusions.

Understanding one’s genotype can guide medical decisions, such as identifying risks for genetic disorders, tailoring personalised treatments, and informing reproductive choices.

It also helps in understanding ancestry and can provide insights into how genetics contribute to overall health and development.

When choosing a life partner, knowing the genotypes of both partners is important, For instance, if both partners have the AS genotype, there is a 25 per cent chance with each pregnancy of having a child with sickle cell disease (SS genotype).

In these scenarios, understanding genotypes helps in making informed decisions that promote health and well-being, reducing the risk of genetic disorders in offspring and ensuring safe medical procedures.

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Muhammad stated that some individuals may resort to dishonest methods to obtain a desired genotype result due to certain pressures.

“There are some individuals who may wish to have a particular genotype and  are ready to go through dishonest ways to get fake results. Some people go to business centres to produce fake genotype result as if obtained from laboratories. Therefore it is best to go to a standard lab or standard hospitals to do the investigations,” Muhammad said.

Aderayo Olasunkanmi, had a similar issue with Nike but hers was on blood type. She noted that her blood group was O+ but when she got tested in her school clinic it was B+.

“When I was small and my parents took me to the hospital to conduct the test, they told me that my genotype was AS and my blood group was O+. when I grew older, I was able to confirm it myself from the document.

“But when I got admission into the university and I had to do my clinic registration, I was tested to be B+ but my genotype remained the same which left me puzzled,” she noted.

Nike (mentioned earlier) opted to retake the test from a different lab to be sure and the test was the same as her initial genotype as she said.

“I ran a second test [third test in total] yesterday. The result is “AS” … Same result with the one I did years ago.  This makes it the third genotype test I’ve done all together since birth. Do I have to rerun a 4th test?”, she asked.

She now has an AS, AA and AS result.

Why there are inconsistent results 

Inconsistent test results can lead to uninformed decisions, increasing the risk of genetic disorders in offspring. Addressing these inconsistencies is essential to ensure reliable genetic information for medical and personal decision-making.

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Muhammad noted that in blood grouping and genotype testing, it is essential to use an accredited laboratory that adheres to proper procedures.

The reagents must be in good condition and stored correctly, as improper storage can affect the results. Blood samples must be collected in appropriate containers and placed on a tile for testing.

“There are three main sources of error in blood grouping; pre-analytical, analytical, and post-analytical”, the consultant stated.

Pre-analytical stage errors 

Speaking on the errors she said “during the pre analytical, that is when the sample is being taken. You have to identify the person or the patient that is doing the blood group, check their details and the sample so as not to mix the sample with another name.

When the sample is collected it should be done in at least four hours at room temperature. If you are going to keep the sample in the lab or at room temperature, if you are not running the sample immediately, it should be refrigerated.”

Analytical sources of errors 

She explained that analytical sources of errors are the errors that may occur while the test is being done.

“For instance when an instrument is not properly cleaned, you may pick some of the anti sera blood from one portion to another portion and that can affect the reaction because you have mixed two different reactions that can give you a wrong blood group.

Another source of analytical errors is when using reagents that are not properly stored or that have expired,” she emphasised.

Post-analytical stage errors

She stated that the errors that can occur in the post-analytical stage is when the results are not written or recorded on the system properly.  There might be typographical errors and most times when there are irregularities in tests it is in the documentation.




     

     

    “The common irregularities are human factors, either the person is not qualified to do the testing or the lab is not qualified to do the investigations or there is error in documentation of the person’s details and therefore mixing of results. There could be error in documenting the final results.”

    Discrepancies are very rare because most of the errors are usually documentation errors. This means when you refer to the investigation, you always see the correct test that was done likewise for genotype.

    However there are a lot of fake genotype around because people change results that have been given to them in laboratories  because of the pressure put on them for the desired genotypes for pre marital testings or investigations.”

    She stated further that irregularities in blood grouping are easily detectable. Blood group information is typically requested during blood transfusion or donation. Blood grouping is often checked multiple times during these processes to ensure accuracy.

    Fatimah Quadri is a Journalist and a Fact-checker at The ICIR. She has written news articles, fact-checks, explainers, and media literacy in an effort to combat information disorder.
    She can be reached at sunmibola_q on X or [email protected]

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