Abstract:
Children with sickle cell trait (HbAS) are protected against severe and symptomatic
Plasmodium falciparum malaria. While several within-host resistance mechanisms have
been investigated, it is unknown whether this protection may be attributable in part to
reductions in exposure to P. falciparum parasites via mosquito bites. In a 15-month
28 cohort in Western Kenya, we matched mosquito bloodmeals to human hosts based on
short tandem repeat (STR) genotypes to determine individual mosquito biting rates.
Using a multilevel multivariable model, we assessed mosquito biting behavior with
respect to human b-globin genotypes and found no significant difference in the biting
rates between individuals with HbAA and HbAS genotypes (biting rate ratio (BRR): 1.23,
95% CI: 0.86 - 1.77). These findings suggest that protection from malaria conferred by
sickle trait is likely not attributable to reduced exposure to infectious mosquito bites
