New Osteological Data on Malaria in Sardinia from Antiquity to the Modern Era

Abstract

Malaria has been an important disease throughout the history, particularly in the Mediterranean. The island of Sardinia (Italy) was characterized by severe endemic malaria from antiquity until its eradication in 1950. It provides an exceptional and unique site to examine the history of the disease and its effects on human biology and ecology. Endemic malaria can cause chronic hemolytic anemias that may result in osteological signatures. This paper examines these markers, Porotic Hyperostosis (PH) and Cribra Orbitalia (CO), which are identified from skeletons uncovered in archaeological excavations in Northern Sardinia. Previous hypotheses based on historical references and genetic data suggest that the disease was absent on the island in prehistory and was imported, probably by slaves, during the Carthaginian period (6th to 3rd century BC). This article reports on the paleontological analysis of 283 skeletons excavated from seven archeological sites dating from 4700 BP to 1582 AD. Osteological remains were examined for markers CO and PH as a proxy variable for malaria. The findings support previous hypotheses about history of malaria over time.

Malaria in Europe: A Historical Perspective

“…The authors have indeed argued that this area was surrounded by marshes during the Roman period (83). An osteological study conducted in Sardinia for the so-called "malaria signature" on 283 skeletons dating from 4,700 BC to 1582 AD, supported the possible introduction of malaria by Carthaginians during the 6th to 3rd century BC (84). Porotic hyperostosis is the consequence of thalassemia resulting in an overgrowth of the spongy marrow space of the skull.…”

The changing malaria risk patterns in East‐Central Europe and the North Balkans in the last 27 000 years

“…In the example of the anthropological material of a Greek colonial population from the 5th to 3rd centuries bce , Keenleyside and Panayotova (2006) showed that nutritional deficiencies, thalassemia, sickle cell traits, and exposure to infectious diseases such as malaria could play an equal role in the development of the above‐mentioned skeletal lesions that can be pathognomonic skeletal signs in malaria. Interestingly, cribra orbitalia or cribra crania was found in high prevalence in medieval age cemeteries in Sardinia, but not in the Bronze Age and Roman and rarely in Neolithic sites (Tognotti et al ., 2017).…”