Reduced soluble transferrin receptor concentrations in acute malaria in Vanuatu

Soluble transferrin receptor (sTfR) concentration is a sensitive index of i ron deficiency when used in conjunction with ferritin measurements in adult s. One advantage of this assay is that unlike ferritin it does not appear t o be affected by a range of infectious and inflammatory conditions or by pr egnancy, rendering it a promising adjunct to the diagnosis of iron deficien cy in tropical populations. We have measured plasma sTfR concentrations in a group of malaria patients (n = 21) and asymptomatic (18) and aparasitemic (76) controls in Vanuatu. Plasma sTfR concentration was significantly redu ced in individuals with acute malaria (P = 0.003). While this observation p rovides evidence that erythropoeitic suppression may be an important etiolo gic component in malarial anemia, it also suggests that malaria may be a co nfounding factor when interpreting sTfR concentrations in such populations. The role of sTfR in the diagnosis of iron deficiency in tropical populatio ns remains to be established.