Document Detail

Epidemiological approach to the paleopathological diagnosis of leprosy.
MedLine Citation:
PMID:  11471136     Owner:  NLM     Status:  MEDLINE    
In paleopathology it is usually assumed that modern diagnostic criteria can be applied to infectious diseases in the past. However, as both the human species and populations of pathogenic microorganisms undergo evolutionary changes, this assumption is not always well-founded. To get valid estimates of the frequency (the point prevalence at death) of leprosy in skeletal samples, sensitivity, specificity, and sample frequency must be estimated simultaneously. It is shown that more than three symptoms must be evaluated in at least three samples in order to reach estimates with well-described properties. The method is applied to three skeletal samples from Medieval Denmark; the samples were scored for the presence of seven osteological conditions indicating leprosy. For the osteological conditions, sensitivity varied from 0.36-0.80, and specificity from 0.58-0.98. The frequency of leprosy in the three samples was: Odense (a lepers' institution), 0.98, 95% CI 0.64-1.00; Malmö (urban cemetery), 0.02, 95% CI 0.00-0.07; and Tirup (rural cemetery), 0.36, 95% CI 0.23-0.46. It is concluded that it is indeed possible to estimate disease frequencies without reference to modern standards, and that leprosy occurred with widely differing frequencies in different segments of the Medieval population in southern Scandinavia.
J L Boldsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of physical anthropology     Volume:  115     ISSN:  0002-9483     ISO Abbreviation:  Am. J. Phys. Anthropol.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-07-25     Completed Date:  2001-08-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0400654     Medline TA:  Am J Phys Anthropol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  380-7     Citation Subset:  IM    
Copyright Information:
Copyright 2001 Wiley-Liss, Inc.
Anthropological Data Base Odense University and Danish Center for Demographic Research, SDU-Odense University, DK 5000 Odense, Denmark.
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MeSH Terms
Anthropology, Physical
Bone and Bones / pathology*
Epidemiologic Studies
Leprosy / diagnosis*,  pathology
Reference Values
Sensitivity and Specificity

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