Dangvard Pedersen Dorthe, Milner George R, Kolmos Hans Jørn, Boldsen Jesper Lier
Unit of Anthropology (ADBOU), Department of Forensic Medicine, University of Southern Denmark, Denmark.
Department of Anthropology, Pennsylvania State University, USA.
Int J Paleopathol. 2019 Dec;27:101-108. doi: 10.1016/j.ijpp.2018.11.003. Epub 2018 Dec 3.
Millions of people worldwide have sickened and died from tuberculosis in recent centuries. Yet for most of human existence, the impact of tuberculosis on society is largely unknown. It is, indeed, unknowable without methods suitable for estimating disease prevalence in skeletal samples. Here such a procedure is applied to medieval and early modern Danish skeletons, and it shows how disease prevalence varied with differences in socioeconomic conditions. The approach is based on sensitivity and specificity estimates from modern skeletons. To augment our understanding of tuberculosis in Danish history, 713 adult skeletons were examined, all from Ribe. Tuberculosis increased from 17% to 40% in the medieval to early modern periods in Ribe. Low status (29%) people were more likely to contract the disease than those of high status (10%). The general model, derived from the modern expression of tuberculosis, fits the early modern sample better than it does the medieval skeletons. Differences in the model's fit indicate the skeletal expression changed over time. Notably, rib lesions increased in frequency from the medieval to early modern periods. The approach developed here can provide insights into host-pathogen relationships and disease expression in future work with tuberculosis and other diseases that affect the skeleton.
近几个世纪以来，全球数以百万计的人因结核病患病甚至死亡。然而，在人类存在的大部分时间里，结核病对社会的影响很大程度上不为人知。事实上，如果没有适用于估算骨骼样本中疾病患病率的方法，这是无法得知的。这里将这样一种程序应用于中世纪和近代早期的丹麦骨骼，它展示了疾病患病率如何随着社会经济状况的差异而变化。该方法基于对现代骨骼的敏感性和特异性估计。为了加深我们对丹麦历史上结核病的理解，研究人员检查了713具成年骨骼，这些骨骼均来自里伯。在里伯，结核病在中世纪到近代早期的患病率从17%上升到了40%。社会地位低的人（29%）比社会地位高的人（10%）更容易感染这种疾病。从现代结核病表现推导出来的一般模型，对近代早期样本的拟合度比对中世纪骨骼的拟合度更好。模型拟合度的差异表明骨骼表现随时间发生了变化。值得注意的是，从中世纪到近代早期，肋骨病变的频率增加了。这里开发的方法可以为未来研究结核病和其他影响骨骼的疾病中的宿主 - 病原体关系及疾病表现提供见解。
