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

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 Previous hypotheses based on historical references and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.