Sickle-trait hemoglobin does not influence Anopheles biting rates.

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 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 β-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.