Abstract. Soluble transferrin receptor (sTfR) concentration is a sensitive index of iron deficiency when used in conjunction with ferritin measurements in adults. One advantage of this assay is that unlike ferritin it does not appear to be affected by a range of infectious and inflammatory conditions or by pregnancy, rendering it a promising adjunct to the diagnosis of iron deficiency in tropical populations. We have measured plasma sTfR concentrations in a group of malaria patients (n ϭ 21) and asymptomatic (18) and aparasitemic (76) controls in Vanuatu. Plasma sTfR concentration was significantly reduced in individuals with acute malaria (P ϭ 0.003). While this observation provides evidence that erythropoeitic suppression may be an important etiologic component in malarial anemia, it also suggests that malaria may be a confounding factor when interpreting sTfR concentrations in such populations. The role of sTfR in the diagnosis of iron deficiency in tropical populations remains to be established.The diagnosis of iron deficiency can be difficult in tropical communities. Routine tests can be unreliable; for example, microcytosis is a poor indicator in populations where hemoglobinopathies are common 1,2 and acute malaria can result in both anemia 3 and elevated serum ferritin concentrations. 4,5 The transmembrane iron transport protein transferrin receptor (CD71) is a dimeric protein consisting of two identical 95-kD subunits. During red blood cell maturation, membrane transferrin receptor is degraded by endosomal digestion and an 85-kD fragment, soluble transferrin receptor (sTfR), is released into the circulation. 6 Plasma levels can be measured using a sensitive ELISA method. It has been estimated that 80% of circulating sTfR originates from developing red blood cells. The STfR concentration is pathologically increased in the presence of tissue iron deficiency, 7,8 and has been shown to be a sensitive index of this condition when interpreted in conjunction with ferritin measurements in adults. 7,8 Unlike ferritin, sTfR is not affected by a range of infections, inflammatory conditions or by pregnancy 9,10 and might thus be a useful tool in the assessment of iron status in tropical populations. We have investigated this possibility by measuring both sTfR and ferritin concentrations in malaria patients and control subjects living in Vanuatu.