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Antibodies against\n                      <jats:italic>Anopheles<\/jats:italic>\n                      salivary proteins measured at the individual level may serve as proxy biomarkers for vector exposure and malaria transmission, but their relationship is yet to be quantified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A systematic review of studies measuring antibodies against\n                      <jats:italic>Anopheles<\/jats:italic>\n                      salivary antigens (PROSPERO: CRD42020185449). Multilevel modelling (to account for multiple study-specific observations [level 1], nested within study [level 2], and study nested within country [level 3]) estimated associations between seroprevalence with\n                      <jats:italic>Anopheles<\/jats:italic>\n                      human biting rate (HBR) and malaria transmission measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      From 3981 studies identified in literature searches, 42 studies across 16 countries were included contributing 393 study-specific observations of anti-\n                      <jats:italic>Anopheles<\/jats:italic>\n                      salivary antibodies determined in 42,764 samples. A positive association between HBR (log transformed) and seroprevalence was found; overall a twofold (100% relative) increase in HBR was associated with a 23% increase in odds of seropositivity (OR: 1.23, 95% CI: 1.10\u20131.37; p&lt;0.001). The association between HBR and\n                      <jats:italic>Anopheles<\/jats:italic>\n                      salivary antibodies was strongest with concordant, rather than discordant,\n                      <jats:italic>Anopheles<\/jats:italic>\n                      species. Seroprevalence was also significantly positively associated with established epidemiological measures of malaria transmission: entomological inoculation rate,\n                      <jats:italic>Plasmodium<\/jats:italic>\n                      spp. prevalence, and malarial endemicity class.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Anopheles<\/jats:italic>\n                      salivary antibody biomarkers can serve as a proxy measure for HBR and malaria transmission, and could monitor malaria receptivity of a population to sustain malaria transmission. Validation of\n                      <jats:italic>Anopheles<\/jats:italic>\n                      species-specific biomarkers is important given the global heterogeneity in the distribution of\n                      <jats:italic>Anopheles<\/jats:italic>\n                      species. Salivary biomarkers have the potential to transform surveillance by replacing impractical, inaccurate entomological investigations, especially in areas progressing towards malaria elimination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"abs5\">\n                    <jats:title>Funding:<\/jats:title>\n                    <jats:p>Australian National Health and Medical Research Council, Wellcome Trust.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7554\/elife.73080","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T08:09:02Z","timestamp":1640160542000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.73080","source":"Crossref","is-referenced-by-count":27,"title":["Anopheles salivary antigens as serological biomarkers of vector exposure and malaria transmission: A systematic review with multilevel modelling"],"prefix":"10.7554","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8912-8067","authenticated-orcid":true,"given":"Ellen A","family":"Kearney","sequence":"first","affiliation":[{"name":"The McFarlane Burnet Institute of Medical Research and Public Health","place":["Melbourne, Australia"]},{"id":[{"id":"https:\/\/ror.org\/01ej9dk98","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne","place":["Melbourne, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A","family":"Agius","sequence":"additional","affiliation":[{"name":"The McFarlane Burnet Institute of Medical Research and Public Health","place":["Melbourne, Australia"]},{"id":[{"id":"https:\/\/ror.org\/01ej9dk98","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, 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