In recognition of World Humanitarian Day 2018, PLOS ONE Senior Editor Adya Misra reflects on the Medecines Sans Frontières Scientific Research Day held earlier this year. Medecines Sans Frontières (MSF) are perhaps best known for
Southwest of Cairo, the Nile branches into a network of canals that feed Fayum, a fertile agricultural basin that was a center of civilization and royal pyramid-building for several centuries. The unusual geology responsible for Fayum’s rich terrain may have also led to the prevalence of malaria and tuberculosis in the region during these ancient times.
Ancient DNA (aDNA) from sixteen mummified heads recovered from the region reveals that at least four of these individuals suffered both these infections simultaneously. Many of the others showed signs of infection with either malaria or tuberculosis, as scientists report in a recent PLOS ONE study.
DNA extracted from muscle tissue samples was tested for the presence of two genes specific to Plasmodium falciparum, the malarial parasite, and another gene specific to Mycobacteria, which cause tuberculosis. Two samples tested positive for DNA specific to Plasmodium, one tested positive for the mycobacterial gene, and four individuals tested positive for DNA from both infectious agents, suggesting they suffered both infections together while alive. A previous study suggests that both malaria and tuberculosis were rampant in the Fayum region in the early 19th century, but the age of these mummified samples extends evidence of these diseases in Lower Egypt as far back as approximately 800 B.C.
The World Health Organization estimates that malaria is almost non-existent in the Fayum basin and the rest of Egypt now, but before its eradication, high levels of infection were seen in certain parts of the country, and were strongly linked to certain geological features. The lakes and canals that made the Fayum region so fertile also served as breeding grounds for the mosquito that carries the malarial parasite.
The heads tested here (all were missing bodies) were recovered from a village cemetery on the west bank of the lower Nile, and date from about 1064 BC to 300 AD, a period marked by an agricultural boom and dense crowding in the region, especially under the rule of the Ptolemies. These conditions may have increased the chances of tuberculosis incidence and spread of the disease. As the aDNA from these mummified heads attests, these living conditions and the unique irrigation of the Fayum basin likely created a harbor for both malaria and tuberculosis in ancient populations of this region.
Citation: Lalremruata A, Ball M, Bianucci R, Welte B, Nerlich AG, et al. (2013) Molecular Identification of Falciparum Malaria and Human Tuberculosis Co-Infections in Mummies from the Fayum Depression (Lower Egypt). PLoS ONE 8(4): e60307. doi:10.1371/journal.pone.0060307
Image: Sailing on the Nile by David Corcoran
One of the world’s deadliest infectious diseases has been with us since the time of the ancient Greeks and Romans. It has been found in thousand-year-old Egyptian mummies and is still present in millions of homes today. What is this ancient disease you may ask? Tuberculosis.
Pulmonary tuberculosis (TB) is a contagious bacterial infection in the lungs, which can spread to other organs. According to the CDC, TB is one of the most common infectious diseases in the world. And although significant progress has been made to eliminate this illness, 9 million new cases of tuberculosis were reported in 2011.
Tuberculosis is spread when an individual is exposed to a sneeze or cough of a person suffering from the disease. TB can also be contracted if someone has poor nutrition or living conditions. In some cases, the infection can lie dormant in the body for years, and in others, it may become active and cause major complications. The primary stage of tuberculosis has no symptoms, but as the disease progresses, patients can suffer from bloody coughs, fatigue, fever and weight loss.
Ancient Roman physicians recommended treatments including bathing in human urine, eating wolf livers and drinking elephant blood. Today, though, modern medicine has found that Tuberculosis is preventable and treatable by more modern methods, with early treatment being essential to stopping its progression.
In honor of World TB Day, observed yesterday on March 24th, here are some recently published papers from PLOS ONE on the subject:
Diabetes is a risk factor for TB, and it can also affect the severity of the infection and success of treatment. In a recent study, authors have researched the connection between diabetes, smoking and tuberculosis. The cohort study featured patients suffering from their first episode of tuberculosis. Out of the 657 participants analyzed, diabetes was present in 25 percent, which increased the risk of death in the first 12 months after enrollment. Tobacco smoking also increased the risk of TB and caused further complications among diabetic patients.
In another recently published paper, researchers have investigated the outcome of aggressive treatments for multidrug-resistant tuberculosis. The patients analyzed were treated in a national outpatient program in Peru from 1999 to 2002. Participants received individualized regimens for laboratory-confirmed tuberculosis. In this cohort examination, authors found that TB was cured in 66 percent of the patients, showing that aggressive regimens for multidrug-resistant tuberculosis can be extremely successful.
Lastly, the link between poverty and TB has been well established, but the mechanisms behind this link have not. In a third PLOS ONE paper, authors investigated why the poor are at a greater risk for tuberculosis in India. With data from the 2006 Demographic Health Survey, researchers analyzed incidences of TB and household economic status. They found low body mass index and air pollution may be partly responsible for the link between poverty and tuberculosis.
Further initiatives are needed to assist in the global eradication of tuberculosis. To expand your own awareness of this infectious disease, please explore additional PLOS ONE research here.
Reed GW, Choi H, Lee SY, Lee M, Kim Y, et al. (2013) Impact of Diabetes and Smoking on Mortality in Tuberculosis. PLoS ONE 8(2): e58044. doi:10.1371/journal.pone.0058044
Mitnick CD, Franke MF, Rich ML, Alcantara Viru FA, Appleton SC, et al. (2013) Aggressive Regimens for Multidrug-Resistant Tuberculosis Decrease All-Cause Mortality. PLoS ONE 8(3): e58664. doi:10.1371/journal.pone.0058664
Oxlade O, Murray M (2012) Tuberculosis and Poverty: Why Are the Poor at Greater Risk in India? PLoS ONE 7(11): e47533. doi:10.1371/journal.pone.0047533
Image: By isafmedia on Flickr