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Fig. 4 | Malaria Journal

Fig. 4

From: Testing an infection model to explain excess risk of preterm birth with long-term iron supplementation in a malaria endemic area

Fig. 4

Synergistic effects of dual exposure with chronic malaria and enteric infection in iron supplemented adolescents and increased risk of preterm birth. Red arrows: malaria loop; blue arrows: enteric loop; black arrows: iron pathway; brown arrows: preterm pathway. Numbers in square brackets refer to manuscript references with evidence for the specific pathway events. Box texts refer to pathophysiological consequences and stages in the specific pathways. Body iron stores refers to the observation that in the PALUFER trial mean body iron stores were higher in pregnant women with malaria [14], indicating that better iron status was associated with increased malaria infection risk. Nulliparous participants were individually randomized to receive either a weekly capsule containing ferrous gluconate (60 mg elemental iron, 479 mg gluconate) and folic acid (2.8 mg), or an identical capsule containing folic acid alone (2.8 mg). CRP: C-reactive protein; NO: nitric oxide; LPS: lipopolysaccharide; pro-inflammatory cytokines are interleukin (IL)-1 beta (β); IL-6; IL-8; interferon (IFN) gamma (ɣ); Nod-Like Receptor (NLR)P3: gene belonging to the NLRP3 inflammasome complex

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