The iron link between malaria and invasive non-typhoid Salmonella infections

• Malaria and non-typhoid Salmonella infections frequently co-occur.
• We speculate that iron may play a central role in this association.
• Malaria leads to iron sequestration in macrophages.
• Iron sequestration in macrophages increases survival of Salmonella spp.
• This might also contribute to the adverse effects of iron therapy in malaria areas.

Epidemiological studies have demonstrated an association between malaria and invasive non-typhoid Salmonella (NTS) infections, especially in children. We explore the role of iron as a possible cofactor in this association. Malarial disease, among others, is associated with enhanced erythrophagocytosis and inflammation, which increases the iron content of macrophages and thereby also the survival of Salmonella spp. within macrophages. Whether iron supplementation programs augment the risk of invasive NTS infections in malaria-endemic regions is an important global health issue that still needs to be determined.