Irrigation and Infection: A Bioethnography of Schistosomiasis in Ancient Nubia Público

Abstract

Irrigation use can significantly influence the epidemiology of schistosomiasis.
The infection is transmitted by aquatic snails, and canal irrigation compounds exposure
risk by increasing snail habitat and time spent in contact with contaminated water. In
modern populations schistosomiasis has been deemed "the most important water-based
disease from a global public-health perspective," yet little is known about the impact of
schistosomiasis on populations living in the past.

To better understand the influence of different forms of irrigation on the burden of
schistosomiasis disease in ancient populations, an enzyme-linked immunosorbent assay
(ELISA) was used to detect antigens specific to Schistosoma mansoni in desiccated tissue
samples from two Nubian populations, one that used saqia canal irrigation (Wadi Halfa,
N=46) and one that used annual flooding (Kulubnarti, N=191). Based on evidence
regarding the impact of canal irrigation on schistosomiasis prevalence and transmission
in modern populations, the prevalence of infection was predicted to be higher in Wadi
Halfa than Kulubnarti, peak infection intensity was predicted to occur at an earlier age
and at a higher level within the Wadi Halfa population and the prevalence of
schistosomiasis to be higher in males than females in both populations.

The prevalence of S. mansoni was greater in the Wadi Halfa population (26.1%)
than at Kulubnarti (9.4%)(p=0.002). However, peak prevalence of infection did not occur
in a younger age category within the Wadi Halfa population; prevalence of infection
peaked at 66.7% in the mature adult age group (46+ years) in the Wadi Halfa population
and at16% in the later child age group (6-10 years) in the Kulubnarti population. There
were no statistically significant differences in prevalence between males and females of
either population.

I also examined the influence of irrigation use and schistosomiasis on the
productive capacity of the populations. Using disability estimates from modern
populations, the expected reduction in the productive capacity of each population was
calculated. The population at Wadi Halfa experienced considerably greater disability of
the population due to a higher prevalence of infection; this required a five times greater
increase in the productivity of the uninfected population to offset the reduced
productivity of infected members.

Table of Contents

Chapter 1: Introduction 1
Chapter 2: Bioarchaeology and Bioethnography 4
Paleoepidemiology: A Population Perspective on Paleopathology 4
General Stress Perspective: Utilizing Multiple Indicators of Stress 7
Cultural Buffering and Political-Economic Perspectives 10
Historical Context: Ecological & Social 12
Host Resistance 13
Bioarchaeology as Anthropology 15
Chapter 3: Schistosomiasis 18
Lifecycle & Transmission 19
Pathology 21
Paleoparasitic Research 24
Relation to Skeletal Stress Indicators 27
Conclusions 28
Chapter 4: Cultural and Ecological Context 29
Nubia and the Nile 29
Wadi Halfa and the Ballana Period (350-550 BCE) 32
Political and Economic 32
Material and Other Culture 33
Settlement 36
Ecology & Agriculture 37
Schistosomiasis in Context 40
Kulubnarti and the Christian Period 550-1000 BCE 41
Political and Economic 43
Material & other Culture 44
Settlement 46
Ecology & Agriculture 47
Schistosomiasis in Context 48
Chapter 5: Health and Well-being at Wadi Halfa and Kulubnarti 51
Demographic Patterns 52
Growth and Development 53
Diet 55
Disease and trauma 56
Bioarchaeology of Wadi Halfa 57
Demographic Patterns 57
Growth and Development 58
Diet 59
Disease and Trauma 61
Bioarchaeology of Kulubnarti 62
Demographic Patterns 63
Growth and Development 63
Diet 67
Disease and Trauma 67
Key Distinctions between Wadi Halfa and Kulubnarti 68
Conclusions 69
Chapter 6: Research Design 71
Hypotheses 71
Hypothesis 1 71
Hypothesis 2 72
Hypothesis 3 72
Sample 73
Data Collection: ELISA Diagnosis 76
Sample Preparation 76
ELISA 78
Epidemiologic Analysis 81
Limitations 82
Chapter 7: Immunoepidemiology of Schistosomiasis 85
Interpopulation Prevalence Difference - Wadi Halfa v. Kulubnarti 85
Age at Peak Infection Prevalence 88
Sex differences in prevalence 89
Discussion 90
Conclusions 95
Chapter 8: Parasitism and Productivity 98
Irrigation and Productivity in the Nile Valley 101
Schistosomiasis and Productivity 104
Ecological/social Context 107
Wadi Halfa - Ballana Period (350-550 CE) 107
Kulubnarti - Christian Period (550-1000 CE) 108
Analytic Methods 110
Results 113
Discussion 115
Conclusions 116
Chapter 9: Conclusions 119
Literature Cited 124

About this Dissertation

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School	Laney Graduate School
Department	Anthropology
Degree	PhD
Submission	Dissertation
Language	English
Research Field	Anthropology, Physical
Palavra-chave	paleoparasitology paleopathology
Committee Chair / Thesis Advisor	Armelagos, George, Emory University
Committee Members	Secor, W. Evan, CDC, DPD Hadley, Craig, Emory University Kingston, John, Emory University

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