Human antibodies against Anopheles salivary proteins: emerging biomarkers of mosquito and malaria exposure.

Antibodies developed against Anopheles mosquito salivary proteins injected during biting may serve as proxy biomarkers of Anopheles biting exposure. Anti-salivary biomarkers are being increasingly investigated, with ~60 studies published to date, mostly identifying positive associations with Anopheles human biting rates (HBRs). However, several literature gaps must be addressed to inform the application of anti-salivary biomarkers for serosurveillance of vector exposure and malaria transmission and in vector-control trials. We highlight the need for more studies that collect HBRs and antibody data contemporaneously, investigate novel antigens for non-African Anopheles species, and characterize antibody kinetics to understand how biomarkers can track changes in exposure over time. Together, these directions may improve upon insensitive manual mosquito catch techniques and strengthen malaria surveillance programs.