Typhomalaria co-infection: Revisiting two tropical diseases from immunological perspective

Objective: This review explores the immunological interplay between Plasmodium spp. and Salmonella spp. Material and methods: The review was conducted through searches of PubMed, Scopus, Web of Science, and Google Scholar using keywords related to typhomalaria co-infection. Articles discussing epidemiology, clinical features, immunological mechanisms, and diagnostic approaches were included, with no language restrictions. Relevant findings were synthesized qualitatively due to heterogeneity in study designs and outcomes. Results: Reported co-infection rates vary widely across settings (e.g., 30.3% in Cameroon). This variation was influenced by socioeconomic, demographic, and environmental factors. Immunologically, Plasmodium-induced hemolysis, complement depletion, and impaired macrophage function increase susceptibility to Salmonella infection, while dual infection augments pro-inflammatory cytokine release, Toll-like receptor activation, and oxidative stress. These mechanisms contribute to heightened disease severity, including hepatosplenomegaly, anemia, and septicemia. Conclusion: Typhomalaria co-infection exacerbates clinical outcomes via synergistic immunopathological mechanisms. Clinicians in endemic regions should maintain a high index of suspicion and employ comprehensive diagnostic strategies.