Asian Journal of Transfusion Science
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The prevalence of Dia, Mia, and Mur antigens among Malaysians and Indians

 Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India

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Date of Submission20-Jan-2021
Date of Decision14-Apr-2021
Date of Acceptance18-Apr-2021
Date of Web Publication26-Sep-2022

How to cite this URL:
Polavarapu I, Shastry S. The prevalence of Dia, Mia, and Mur antigens among Malaysians and Indians. Asian J Transfus Sci [Epub ahead of print] [cited 2023 Mar 23]. Available from:


Low-incidence red cell antigens can be defined as those which are known to occur in <1% of individuals in most populations. The Dia antigen of Diego blood group system has a low incidence among Caucasians but occurs commonly among Asians of Mongoloid origin.[1] Anti-Dia has been known to cause hemolytic disease of newborn and delayed hemolytic transfusion reactions. The Mia and Mur are low frequency antigens belonging to the Miltenberger subsystem of MNSs blood group system. Incidence of anti-Mia and Mur antibodies has been mostly reported among Chinese population, and they are implicated in hemolytic disease of fetus and newborn. The present report gives the prevalence of Dia antigen, Mia, and Mur antigens among voluntary blood donors of Malaysia and India.

We conducted a prospective observational study over a period of 7 months (August 2018 to February 2019) at department to transfusion medicine attached to a tertiary care hospital. We screened the blood samples of 75 consecutive voluntary blood donors of Malaysian ethnicity and 97 donors of Indian Ethnicity for Dia, Mia, and Mur antigens using commercially available antisera. The sample size was calculated considering 95% of confidence interval, 5% margin of error, and the prevalence of 1.25% (taken from the literature) and the minimum sample size found to be 19. Column Agglutination Technology was used for antigen typing (Bio-Rad (DiaMed, GmbH, Switzerland). The Malaysian donors comprised 43 males (57.3%) and 32 female donors (42.7%). The distribution of blood group A, B, O, and AB among the Malaysian donors was 26.7%, 21.3%, 48%, and 4%, respectively. The prevalence of the Dia, Mia, and Mur in the present study and that was found on review of literature is mentioned in [Table 1].
Table 1: The prevalence of Dia, Mia and Mur red cell antigens

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A higher incidence of Dia among the Malaysians in the present study, as compared to the reported literature could be due to the genetic drift as might have taken place. The prevalence of Mia and Mur among Malaysians was 2.7% and 1.3%, respectively. All the three are low prevalence antigens among Indians, whereas it is common among Chinese and Malay population.


We would like to express our gratitude to Dr.Sanmukh R. Joshi, Lok Samarpan Blood bank and Research Centre, Surat, Gujarat for sharing the rare antisera required for the study purpose.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

   References Top

Wei CT, Al-Hassan FM, Naim N, Knight A, Joshi SR. Prevalence of Diego blood group antigen and the antibody in three ethnic population groups in Klang valley of Malaysia. Asian J Transfus Sci 2013;7:26-8.  Back to cited text no. 1
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Mak KH, Banks JA, Lubenko A, Chua KM, Torres de Jardine AL, Yan KF. A survey of the incidence of Miltenberger antibodies among Hong Kong Chinese blood donors. Transfusion 1994;34:238-41.  Back to cited text no. 2
Prathiba R, Lopez CG, Usin FM. The prevalence of GP Mur and anti-“Mia” in a tertiary hospital in Peninsula Malaysia. Malays J Pathol 2002;24:95-8.  Back to cited text no. 3
Komatsu F, Hasegawa K, Yanagisawa Y, Kawabata T, Kaneko Y, Watanabe S, et al. Prevalence of diego blood group Dia antigen in Mongolians: Comparison with that in Japanese. Transfus Apher Sci 2004;30:119-24.  Back to cited text no. 4
Makroo RN, Bhatia A, Chowdhry M, Rosamma NL, Karna P. Frequency of Mi(a) antigen: A pilot study among blood donors. Indian J Med Res 2016;143:633-5.  Back to cited text no. 5
[PUBMED]  [Full text]  

Correspondence Address:
Shamee Shastry,
Department of Immunohematology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal-576104, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajts.ajts_5_21


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