RESUMO
OBJECTIVE: This study attempts to integrate multiple methods to investigate the presence of malaria in human skeletal samples from an archaeological context. MATERIALS: 33 well preserved human remains originating from a 17th-century archaeological site in southeastern Romania. METHODS: The human bone samples were analyzed using rapid diagnostic tests for malaria antigens and PCR amplification of Plasmodium falciparum apical membrane antigen 1. A preliminary test was performed to identify and briefly characterize the presence of hemozoin using a combination of TEM imaging and diffraction. RESULTS: The rapid diagnostic tests indicated that more than half of the examined samples were positive for Plasmodium antigens, but no traces of the parasites' genetic material were detected despite repeated attempts. The TEM images indicated that hemozoin might be a promising diagnostic marker of malaria in ancient bones. CONCLUSIONS: The indisputable identification of malaria in the analyzed archaeological population was not possible as none of the applied methodological strategies turned out to be straightforward. SIGNIFICANCE: This study reinforces the intricacy and limitations of unequivocally identifying malaria in past populations and sets the stage for future studies on such life-threatening infectious disease in a geographical space, which is currently underrepresented in the bioarchaeological literature. LIMITATIONS: The low sample size and the lack of consistency across all assays hindered understanding the role of malaria in the studied population. SUGGESTIONS FOR FURTHER RESEARCH: Further thorough multidisciplinary approaches on malaria detection in ancient settlements would be appropriate to inform our knowledge of its origins, frequency, and pathogen changes over centuries.
