新疆鄯善洋海青铜时代居民眶顶板筛孔样病变的调查

本文对新疆鄯善洋海出土的61例(成年个体45例,未成年个体16例)遗骸进行了眶顶板筛孔样病变的观察。在被调查的成年个体中眶顶板筛孔样病变的患病率为44.4%,未成年个体的患病率为75%,且成年个体眶顶板筛孔样病变的患病率性别差异显著。这种病变的高频率现象,很可能与当时单一的饮食结构、低营养水平及不良卫生状况等因素所诱发的缺铁性贫血有关。为深入研究我国新疆地区古代居民眶顶板筛孔样病变的患病率及其发病原因提供了一组基础数据。     

On the presence of cribra orbitalia in apes and monkeys

One hundred and six skulls of various species of apes and monkeys were examined for the presence of cribra orbitalia. The condition was found in 15 (14.1%) of the animals. As in humans, cribra orbitalia was found localized mainly in the anterior parts of the orbital roof and appeared more frequently in infants and young animals. Only mild degrees of cribra orbitalia, i.e., the porotic type of lesions, were found in this series of animal skulls studied. More advanced degrees of development, as observed in human skulls, were not found. The etiology of the condition is not known; some type of nutritional deficiency is considered to be the most likely cause. The occurrence of cribra orbitalia in animals opens up possibilities of experimental work on the subject and may help to solve the problems of its etiology.     

Factors influencing the etiology of cribra orbitalia in prehistoric Nubia

The present research represents an attempt to explain the occurrence of cribra orbitalia in Nubian skeletal remains associated with Meroitic, X-Group and Christian cultural horizons. The distribution of cribra orbitalia among 285 crania examined revealed a concentration of lesions among infants and aged individuals. While earlier studies have suggested cribra orbitalia may reflect the occurrence of abnormal hemoglobins such as sickle cell anemia or thalassemia, a consideration of the environmental context in which the lesions occurred makes an alternative hypothesis more likely. Particularly in Nubia (past and present), where parasitic infection is high, the diet is poor in iron, weanling diarrhea is frequent and multiparity is the norm, chronic iron deficiency anemia is a more likely causal factor. This interpretation is also compatable with clinical observations of cribra orbitalia among modern individuals suffering from chronic iron deficiency anemia.     

Secular trend and age distribution of cribra orbitalia in Japanese

Cribra orbitalia is currently regarded as an indicator of environmental conditions. The prevalence and severity of this lesion in Japanese populations from prehistoric Jomon to modern times were recorded and discussed. Since the lesion was low in both frequency and grade in the late and final Jomon people from Chiba Prefecture, they presumably lived in relatively favorable environmental conditions. The increased prevalence of the lesion in the medieval Muromachi citizens of Kamakura may be attributed to the poor hygiene and social conditions. The high prevalence and marked severity of the lesion in the citizens of Edo (the old name of Tokyo) in the 17th century suggested that they lived under extremely unfavorable situations of nutrition, sanitation and medical care. Cribra orbitalia was most prevalent in adolescence (81.3%) among the Edo citizens. The incidence of the most severe type of lesion rose gradually during childhood, reached a peak in adolescence, and then gradually decreased with age. These findings would reflect intense marrow hyperplasia in the orbital roof associated with both iron deficiency anemia of long standing during the immature period and increased iron requirement in adolescence. The results obtained support the hypothesis that iron deficiency anemia is the primary factor in the etiology of cribra orbitalia. It was concluded that the incidence and severity of cribra orbitalia due to various anemic reactions reflected the dietary, hygienic, social and environmental circumstances of the populations investigated.     

Paleoepidemiology of cribra orbitalia: Insights from early seventh millennium BP Con Co Ngua,Vietnam

Objectives

We test the hypothesis that the condition(s) leading to the development of cribra orbitalia at Con Co Ngua, an early seventh millennium sedentary foraging community in Vietnam, effectively reduced the resilience of the population to subsequent health/disease impacts. An assessment of both the implications and potential etiology of cribra orbitalia in this specific population is carried out.

Methods

The effective sample included 141 adults aged ≥15 years (53 females, 71 males, and 17 unknown sex) and 15 pre-adults aged ≤14 years. Cribra orbitalia was identified by way of cortical bone porosity of the orbital roof initiated within the diplöic space, rather than initiated subperiosteally. The approach is also robust to the misidentification of various pseudo-lesions. Resultant data was analyzed using Kaplan–Meier survival analysis.

Results

Median survival is higher in adults aged ≥15 years without cribra orbitalia than those with this lesion. For the pre-adult cohort, the opposite pattern is seen where median survival is higher in those with cribra orbitalia than those without.

Conclusion

Adults displayed increased frailty and pre-adults increased resilience with respect to cribra orbitalia. The differential diagnosis for a survival analysis of adults and pre-adults with and without cribra orbitalia included iron deficiency anemia and B12/folate deficiency, parasitism (including hydatid disease and malaria) in addition to thalassemia. The most parsimonious explanation for observed results is for both thalassemia and malaria being the chief etiological agents, while appreciating these conditions interact with, and can cause, other forms such as hematinic deficiency anemias.

     

Trace elements and melanoma.

Melanoma incidence has been steadily increasing in recent years in most western countries, thus suggesting a role of environmental risk factors. Among these determinants, it has been hypothesized that some trace elements of nutritional and toxicological interest may be implicated in the etiology of the disease. We examined patients with newly diagnosed melanoma of the skin and population controls from the Modena province northern Italy. Clinical and dietary data were collected through questionnaires, and toenails were sampled for trace element determination. Levels of cadmium, chromium, lead, selenium, zinc, copper and iron in toenails were measured by inductively coupled plasma optical emission spectrometry and by neutron activation analysis. Data obtained from 58 cases and 58 controls indicated higher levels of copper and lower concentrations of iron in melanoma patients, whilst no other differences were seen for the remaining elements. Patterns of correlations of zinc and copper with the estimated intake of some dietary factors were different between cases and controls. Results of the present study suggest that abnormal intake or metabolism of copper and of iron might be implicated in the etiology of melanoma, whilst they do not indicate an involvement of exposure to cadmium, chromium, lead, selenium and zinc in this disease.     

The character of parietal and orbital alterations in the superfamily Hominoidea (families Hominidae [exclusive of Homo] and Hylobotidae)

Parietal external surface disruption routinely referred to as porotic hyperostosis, and orbital alterations (cribra orbitalia), have been attributed to anemia‐related bone marrow hyperplasia in humans. A recent study in humans identified that they were actually vascular in nature. Skeletons were examined and epi‐illumination surface microscopy was performed on the parietal region and orbit of 156 Hominidae and 123 Hylobotidae to assess if these phenomena were trans‐phylogenetic. Trans‐cortical channels were recognized on the basis of visualized ectocranial surface defects penetrating the parietal; cribra orbitalia, by alteration of the normally smooth orbital roof appearance. Trans‐cortical parietal channels, ranging in size from 20 to 100 µm, are rare in Gorilla and Pan troglodytes and absent in Pan paniscus. They are universally present in adult Pongo abeli and in Hylobatidae, independent of species. Cribra orbitalia was common in Hylobotidae, Pongo pygmaeus and P. abelii, less prevalent in adult P. troglodytes, and not recognized in any Gorilla gorilla or P. paniscus examined. The proliferative form predominated, with the exception of Hylobates concolor and muelleri, in which uncalcified vascular grooves predominated. No correlation was observed between the presence of either trans‐cortical channels or cribra orbitalia and fractures, osteoarthritis, or inflammatory arthritis. Parietal alterations observed in apes are trans‐cortical channels, analogous to those observed in humans, and do not represent porosity. Similarly, cribra orbitalia in apes is confirmed as vascular in nature. The proliferative form apparently represents calcification of blood vessel walls, indistinguishable from observations in humans. Predominant presence in adults rather than in juveniles suggests that both forms are acquired rather than developmental in derivation. Sex and bone alteration/disease‐independence suggests that mechanical, endocrine, and inflammatory phenomena do not contribute to the development of either. Further, independent occurrence of trans‐cortical channels and cribra orbitalia suggests that they do not have a shared etiology.     

Cribra orbitalia,a possible sign of anemia in early historic native populations of the British Columbia coast

Excavated and museum skeletons of the postcontact period revealed cribra orbitalia in four native ethnolinguistic divisions of the British Columbia coast, Haida, Kwakiutl, Nootka, and Coast Salish. Affected skulls were distributed among 25 of 35 localities, indicating widespread occurrence in a mainly heterogeneous population. Manifestations were similar to porotic hyperostosis, and additional lesions in the sample tend to support the concept that cribra orbitalia is related to anemia. Both inherited and acquired disorders may have been involved in the etiology. A uniquely high incidence of 52.9% occurred in immature of the Haida, a relatively homogeneous population. However, marked variability in expression by age group and by sex in the total sample is suggestive of iron-deficiency anemia. The data and historical information parallel modern expectations of susceptibility. Among 454 skulls, cribra orbitalia occurred in 32.7% of growing children and adolescents, 19% of infants and toddlers, 13.3% of adult females, and 4.8% of adult males. Postcontact disruptions and disease may have figured in promoting iron-deficiency anemia, but noted precontact occurrences may also have been due to the disorder.     

An assessment of health and disease in the prehistoric inhabitants of the Mariana Islands

Using a variety of skeletal and dental stress indicators, an assessment of the health and disease of the indigenous inhabitants of the Mariana Islands, the Chamorro, is made. The major hypothesis to be tested is that the Chamorro were relatively healthy and that deviations from the expected, as well as inter-island variation, may reflect environmental, ecological, and cultural differences. The major skeletal series surveyed include sites on Guam (N = 247 individuals), Rota (N = 14), Tinian (N = 20), and Saipan (N = 102). The majority of the specimens are from the transitional pre-Latte (AD 1–1000) and Latte (AD 1000–1521) periods. These data derive primarily from unpublished osteological reports. The indicators of health and disease surveyed include mortality and paleodemographic data, stature, dental paleopathology, cribra orbitalia, limb bone fractures, degenerative osteoarthritis, and infectious disease (including treponemal infection). Where appropriate, tests of significance are calculated to determine the presence of any patterning in the differences observed within and between the skeletal series. Information recorded in prehistoric Hawaiians provides a standard for external comparisons. Several of the larger skeletal series surveyed have paleodemographic features that are consistent with long-term cemetery populations. Females and subadults are typically underrepresented. Most subadult deaths occur in the 2–5 year age interval. Life expectancy at birth ranges from 26.4 to 33.7 years. A healthy fertility rate is indicated for these series. The prehistoric inhabitants of the Mariana Islands were relatively tall, exceeding living Chamorros measured in the early part of the present century. The greater prevalence of developmental defects in the enamel suggests that the Chamorro were exposed to more stress than prehistoric Hawaiians. The low frequency of cribra orbitalia further indicates iron deficiency anemia was not a problem. There are generally low frequencies of dental pathology in the remains from the Mariana Islands. Betel-nut staining is relatively common in all series which may help to explain the relatively low prevalence of dental pathology. Healed limb bone fractures are rare in these skeletal series; the frequency and patterns of fractures suggest accidental injury as the main cause. Greater physical demands involving the lower back region are indicated by a high frequency of spondylolysis, or stress fracture in the lumbar vertebrae in the Chamorro. Likewise, advanced degenerative bone changes, while of low occurrence, are significantly greater in the Chamorro than Hawaiians. The prevalence of skeletal and dental indicators of stress was generally higher in the smaller islands of the Marianas chain (e.g., Rota), islands with fewer resources to buffer environmental catastrophe. Bony changes suggestive of treponemal (probably yaws) disease are common in most of these Marianas Islands skeletal series. Am J Phys Anthropol 104:315–342, 1997. © 1997 Wiley-Liss, Inc.     

Continuity or discontinuity of the life-style in central Italy during the Roman Imperial Age-Early Middle Ages transition: diet, health, and behavior

Dento-alveolar pathologies and alterations (dental wear, caries, abscesses, ante mortem tooth loss (AMTL), calculus, hypoplastic defects, and chipping) and skeletal markers of health (cribra orbitalia and periostitis) were analyzed in two skeletal samples from the necropolises of Quadrella (I-IV c. AD) and Vicenne-Campochiaro (VII c. AD) in the Molise region of central Italy. The aim was to determine if the Roman Imperial Age-Early Middle Ages transition characterized by political, socioeconomic, and cultural transformations affected the biology of these populations, particularly their alimentation and health status. The frequencies of caries and AMTL, similar in the two samples, suggest a high consumption of carbohydrates. The higher levels of heavy wear, calculus, and interproximal chipping in the Vicenne population indicate a greater use of fibrous foods (both meat and others), in line with the dietary model of Germanic peoples. Health conditions do not appear to have been good in either period, as shown by the high frequencies of linear hypoplasia and the presence of cribra orbitalia and periostitis. The diet of the individuals buried with horses of the Vicenne population did not differ from that of the rest of the population, whereas there were evident differences in the use of the teeth for nonmasticatory activities among these individuals. Therefore, from the point of view of alimentation and health status, the profound socioeconomic and cultural transformations during the Late Antiquity-Early Middle Ages transition do not seem to have been translated into a true discontinuity of the two Molisan populations.     

Porotic hyperostosis in a marine-dependent California Indian population

A maize-based iron- and protein-deficient diet is commonly cited as the most important cause of porotic hyperostosis among American Indian agriculturalists. An alternative to this maize dependence hypothesis is suggested by the analysis of 432 crania from the nonagricultural, fish-dependent population of the Channel Island area of southern California. Cribra orbitalia, a form of porotic hyperostosis associated with iron deficiency anemia, is just as common among these fisherpeople, whose diet was rich in iron and essential amino acids, as it is among maize-dependent agriculturalists. Northern Channel Island crania have much more cribra orbitalia than those from the California mainland. The highest incidence is on San Miguel, a small geographically isolated island with a shortage of fresh water and terrestrial resources. The Indians who lived on Santa Cruz, the largest of the northern Channel Islands with the greatest diversity of terrestrial plants and animals, have less cribra orbitalia than those who lived on Santa Rosa or San Miguel Island. This geographical distribution appears to be explained by island-mainland and interisland differences in water contamination, exposure to fish-borne parasites, and nutritional adequacy of the diet. The prevalence of porotic hyperostosis in a population with a heavy dietary dependence on marine resources shows that among prehistoric American Indians, this condition is not always associated with an iron- and protein-deficient diet of cultigens. It seems likely that high nutrient losses associated with diarrheal disease are often more significant in the etiology of porotic hyperostosis than a low dietary intake of essential nutrients.     

Influence of chosen elements on the dynamics of the cariogenic process

This prospective study comprised 140 natural crowns of the teeth extracted from 31 boys and 35 men, as well as 39 girls and 35 women. They were divided into two groups. Group I consisted of primary teeth and group II consisted of permanent teeth. In each group, two subgroups were distinguished: subgroup A containing teeth without caries and subgroup B comprising carietic teeth. Zinc, iron, copper, nickel, chromium, cobalt, lead, cadmium, selenium, and strontium were determined in the samples by using the total reflection X-ray fluorescence method. Significantly higher concentrations of zinc, iron, copper, nickel, selenium, and strontium were detected in the crowns of healthy primary and permanent teeth than in the crowns of the carietic primary and permanent teeth. The concentrations of chromium, cobalt, lead, and cadmium were significantly higher in primary and permanent teeth with caries than in the healthy ones. Judging from the obtained results, we think that lower concentrations of zinc, iron, copper, nickel, selenium, and strontium together with higher concentrations of chromium, cobalt, lead, and cadmium in the carietic primary and permanent teeth, in relation with the respective concentrations of those elements in healthy teeth, can be one of the caries risk factors.     

The Correlation of Serum Trace Elements and Heavy Metals with Carotid Artery Atherosclerosis in Maintenance Hemodialysis Patients

Changes in essential trace elements and heavy metals may affect the atherosclerotic state of patients on maintenance hemodialysis (HD). The aim of the study was to evaluate the relation between the serum levels of some trace elements and heavy metals (iron, zinc, manganese, copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio) and carotid artery intima-media thickness (CIMT) in HD patients. Fifty chronic HD patients without known atherosclerotic disease and 48 age- and sex-matched healthy individuals were included in the study. The serum levels of trace elements (iron, zinc, manganese, copper, and magnesium) and heavy metals (cobalt, cadmium, and lead) were measured by Atomic Adsorption Spectrophotometer (UNICAM-929). CIMT was assessed by carotid artery ultrasonography. The serum levels of iron, zinc, and manganese were lower; levels of copper, magnesium, cobalt, cadmium, lead, and copper/zinc ratio were higher in HD patients compared to controls. CIMT in HD patients were higher than the control group (0.64?±?0.11 vs 0.42?±?0.05, p?相似文献   

Oral and physiological paleohealth in cold adapted peoples: Northeast Asia, Hokkaido

This paper examines variables useful in reconstructing oral (caries, antemortem tooth loss, alveolar defects) and physiological (cribra orbitalia, linear enamel hypoplasia) well-being in two bioarchaeological assemblages from Hokkaido, Japan: Okhotsk (n = 37 individuals) and Jomon (n = 60). Findings are compared and contrasted with each other, with published series from Honshu Japan, and samples from climatically near-equivalent Alaska. It was found that more meaningful comparisons of Hokkaido paleohealth could be made with Alaskan material, rather than the more southerly Jomon. Results were ambiguous with respect to physiological well-being. Low levels of LEH in the cold-adapted samples suggest operating in arctic and subarctic environments with marine-based subsistence regimes is not physiologically expensive. However, the relatively high levels of cribra orbitalia in Hokkaido, relative to Alaska, suggest the picture is not straightforward: the reasons for elevated cribra orbitalia in Hokkaido are unclear. The subarctic and arctic samples formed three broadly similar groupings in terms of oral health profiles: (1) Aleuts and Eskimo; (2) Ipiutak and Tigara; (3) Hokkaido Jomon, Okhotsk, and Kodiak Island. Differences between these groupings could be explained with a combination of sample demographics and subsistence orientations. The extremely high frequency of caries in one sample, caribou hunting Ipiutak, may have been influenced by factors such as low levels of dietary magnesium and potentially cariogenic foodstuffs, such as preparations of caribou stomach contents. It was concluded that oral health profiles are potentially sensitive to differences in subsistence strategies among cold-adapted hunter-gatherers, although they lack predictive value.     

Magnesium,Calcium, and Trace Elements Excretion in 24-h Urine

Urine is a clinical specimen often used in medical diagnostics for monitoring of elements concentrations and kidneys function. We determined the contents of magnesium (Mg), calcium (Ca), zinc (Zn), copper (Cu), iron (Fe), lead (Pb), and cadmium (Cd) in 74 samples of 24-h urine (from 46 women and 28 men). The measurements were realized by the atomic absorption spectrometry (AAS) with atomization in the flame (FAAS) and in the graphite furnace (GFAAS). The received results were the subject of statistical analysis including the sex and age of volunteers. Moreover, correlations between the elements and the relationships between age and amounts of excreted elements with urine were tested. We found the statistically significant higher content of Zn in men’s urine than in women^’s one. Moreover, both adult women and men (>18 years) excreted much more Ca in urine in comparison to young subjects. Only in case of Pb the significant positive correlation between its amount in 24-h urine of all donors and age was stated. The correlation analysis has shown the significant positive relationships between Ca–Mg, Ca–Fe, Mg–Fe, Cu–Fe, Cu–Cd, Fe–Cd, and Pb–Cd in total samples of urine. Basing on our results, we concluded that the gender and age of donors may impact on the elemental status of 24-h urine.     

Trace metals in edible marine molluscs and crustaceans from Lebanon

Samples of the edible tissue of cephalopod molluscs (cuttlefish, squid, octopus) and crustaceans (lobster, shrimp) collected off the coast of Lebanon were found to concentrate similar levels of cadmium, copper, nickel, and chromium. Lead and zinc were highest in the cephalopods and iron was highest in the crustaceans.The molluscs collected from Beirut had higher levels of many metals than those taken from the other locations. The Beirut octopus had higher lead, cadmium, copper, iron, and chromium. Lead, cadmium, and copper were also highest in the Beirut cuttlefish while iron and zinc were elevated. The crustaceans from Beirut showed no strong tendency to concentrate higher metal levels, except for the Beirut lobster which had higher copper than the other samples.In the cuttlefish, the analysis of bone showed generally higher cadmium, zinc, nickel, and chromium but lower copper and iron than the muscle. However, at Beirut, the bone samples had much higher iron. Levels of most metals in the exoskeletons of the lobster and shrimp were quite similar to those in the muscle tissue with the exception of iron in the lobster which was highest in the exoskeleton, and zinc in both crustaceans, which was more highly concentrated in the muscle.     

The causes of porotic hyperostosis and cribra orbitalia: A reappraisal of the iron‐deficiency‐anemia hypothesis

Porosities in the outer table of the cranial vault (porotic hyperostosis) and orbital roof (cribra orbitalia) are among the most frequent pathological lesions seen in ancient human skeletal collections. Since the 1950s, chronic iron‐deficiency anemia has been widely accepted as the probable cause of both conditions. Based on this proposed etiology, bioarchaeologists use the prevalence of these conditions to infer living conditions conducive to dietary iron deficiency, iron malabsorption, and iron loss from both diarrheal disease and intestinal parasites in earlier human populations. This iron‐deficiency‐anemia hypothesis is inconsistent with recent hematological research that shows iron deficiency per se cannot sustain the massive red blood cell production that causes the marrow expansion responsible for these lesions. Several lines of evidence suggest that the accelerated loss and compensatory over‐production of red blood cells seen in hemolytic and megaloblastic anemias is the most likely proximate cause of porotic hyperostosis. Although cranial vault and orbital roof porosities are sometimes conflated under the term porotic hyperostosis, paleopathological and clinical evidence suggests they often have different etiologies. Reconsidering the etiology of these skeletal conditions has important implications for current interpretations of malnutrition and infectious disease in earlier human populations. Am J Phys Anthropol 2009. © 2009 Wiley‐Liss, Inc.     

Lower strontium in two different body matrices in neurodevelopmental disorders: A preliminary report

BackgroundEnvironmental factors, including elemental homeostasis, have not been studied sufficiently in neurodevelopmental disorders (NDD). This study aims to compare the status of 13 elements in blood and deciduous teeth dentine of children having an autism spectrum disorder or attention deficit hyperactivity disorder with typically developing controls.MethodsElements including calcium, phosphorus, magnesium, iron, zinc, copper, chromium, manganese, mercury, lead, cadmium, molybdenum, and strontium in both deciduous teeth and blood were analyzed by inductively coupled plasma mass spectrometry.ResultsStrontium levels in both blood and teeth samples were found to be significantly lower in the NDD group. Additionally, blood cadmium and mercury levels, and copper/zinc ratio were higher in the NDD group.ConclusionsOur results warrant further investigation in a large series of NDD examining symptom levels and genetic variations associated with elemental homeostasis.     

Subadult stress,morbidity, and longevity in Latte Period populations on Guam,Mariana Islands

The frequency and age distribution of linear enamel hypoplasia (LEH) in the dentition of 293 individuals from Latte Period sites (AD 800–1521) on Guam, Mariana Islands, are examined in this study. Individuals dying as subadults (before age 16) and as young adults (ages 16–21) have more frequent LEHs than those who survived to middle or late adulthood, documenting a relationship between LEH-causing stress events and reduced life expectancy. The age distributions of cribra orbitalia and skeletal infection in children who died by age 10 exhibit striking similarities to the etiological age patterns of LEH in children, and those with skeletal infection have more frequent hypoplasias than children without infection. The comorbidity of systemic stress and infection in children, and their impact on life expectancy, are interpreted in the biocultural context of high population density in the large coastal villages of the late prehistoric period in the Marianas. Am J Phys Anthropol 104:363–380, 1997. © 1997 Wiley-Liss, Inc.     

Morbidity in the marshes: using spatial epidemiology to investigate skeletal evidence for Malaria in Anglo-Saxon England (AD 410-1050)

Concerns over climate change and its potential impact on infectious disease prevalence have contributed to a resurging interest in malaria in the past. A wealth of historical evidence indicates that malaria, specifically Plasmodium vivax, was endemic in the wetlands of England from the 16th century onwards. While it is thought that malaria was introduced to Britain during the Roman occupation (AD first to fifth centuries), the lack of written mortality records prior to the post-medieval period makes it difficult to evaluate either the presence or impact of the disease. The analysis of human skeletal remains from archaeological contexts is the only potential means of examining P. vivax in the past. Malaria does not result in unequivocal pathological lesions in the human skeleton; however, it results in hemolytic anemia, which can contribute to the skeletal condition cribra orbitalia. Using geographical information systems (GIS), we conducted a spatial analysis of the prevalence of cribra orbitalia from 46 sites (5,802 individuals) in relation to geographical variables, historically recorded distribution patterns of indigenous malaria and the habitat of its mosquito vector Anopheles atroparvus. Overall, those individuals living in low-lying and Fenland regions exhibited higher levels of cribra orbitalia than those in nonmarshy locales. No corresponding relationship existed with enamel hypoplasia. We conclude that P. vivax malaria, in conjunction with other comorbidities, is likely to be responsible for the pattern observed. Studies of climate and infectious disease in the past are important for modeling future health in relation to climate change predictions.