2,000 Year old ß-thalassemia case in Sardinia suggests malaria was endemic by the Roman period.

OBJECTIVES: The island of Sardinia has one of the highest incidence rates of ß-thalassemia in Europe due to its long history of endemic malaria, which, according to historical records, was introduced around 2,600 years ago by the Punics and only became endemic around the Middle Ages. In particular, the cod39 mutation is responsible for more than 95% of all ß-thalassemia cases observed on the island. Debates surround the origin of the mutation. Some argue that its presence in the Western Mediterranean reflects the migration of people away from Sardinia, others that it reflects the colonization of the island by the Punics who might have carried the disease allele. The aim of this study was to investigate ß-globin mutations, including cod39, using ancient DNA (aDNA) analysis, to better understand the history and origin of ß-thalassemia and malaria in Sardinia. MATERIALS AND METHODS: PCR analysis followed by sequencing were used to investigate the presence of ß-thalassemia mutations in 19 individuals from three different Roman and Punic necropolises in Sardinia. RESULTS: The cod39 mutation was identified in one male individual buried in a necropolis from the Punic/Roman period. Further analyses have shown that his mitochondrial DNA (mtDNA) and Y-chromosome haplogroups were U5a and I2a1a1, respectively, indicating the individual was probably of Sardinian origin. CONCLUSIONS: This is the earliest documented case of ß-thalassemia in Sardinia to date. The presence of such a pathogenic mutation and its persistence until present day indicates that malaria was likely endemic on the island by the Roman period, earlier than the historical sources suggest.

Doenças endémicas e epidémicas em Lourenço Marques no início do Século XX: processos de controlo versus desenvolvimento urbano / Endemic and epidemic diseases in Lourenço Marques in the early 20th Century: forms of control versus urban development

No início do século XX, Lourenço Marques surgia como auspiciosa metrópole na África Austral, sendo a ligação ao Transval apontada como principal responsável pelo seu desenvolvimento. Ali se misturavam gentes de todas as origens e ofícios tornando urgente a implementação de estruturas urbanas e políticas de saúde pública que respondessem às necessidades decorrentes deste surto populacional. No século XIX, as dificuldades na implementação dos Serviços de Saúde tinham evidenciado as consequências deste crescimento, dando origem a reformas e medidas que, não raro, se revelaram insuficientes ou inadequadas às condições tropicais. Doenças endémicas e epidémicas encontravam em Lourenço Marques um meio propício à sua proliferação e, no início de 1900, procuraram- -se e testaram-se estratégias de combate às principais doenças que implicaram o investimento no reforço de medidas preventivas e num número significativo de obras públicas e saneamento. Porém, frequentemente, mais do que atuar na profilaxia destas doenças, relegaram- -nas para a periferia, acentuando dicotomias e desigualdades. Utilizando documentação da Direção dos Serviços de Saúde e da Direção de Obras Públicas este artigo examina a eficácia e os resultados dessas medidas, designadamente no referente à assistência médica ao indígena, no âmbito da medicina tropical e da implantação do sistema colonial em Moçambique.

In the early 20th century, Lourenço Marques emerged as a promising metropolis in southern Africa being the relation with the Transvaal pointed as the main responsible for its development. Therein mingled people of all backgrounds and crafts making imperative to implement urban structures and public health policies to respond the needs arising from this population outbreak. In the 19th century, the difficulties in implementing the Health Services had shown the main consequences of this growth, leading to reforms and legislation that often proved to be inadequate or inappropriate to tropical conditions. Endemic and epidemic diseases found in Lourenço Marques favorable conditions to their proliferation and, as early as 1900, different strategies were considered and tested to combat major diseases. These strategies involved investment in preventive measures and public and sanitation works but, most times, rather than acting in a prophylactic way, they contribute to relegate diseases to the city's periphery, accentuating dichotomies and social inequality. Using the documents of the Health Services and the Public Works Services, this article address the effectiveness and results of these measures, particularly with regard to the indigenous medical care, in the scope of Tropical Medicine and the implementation of the colonial system in Mozambique

The history of the Greek Anti-Malaria League and the influence of the Italian School of Malariology.

In 1905, a group of eminent Greek physicians led by Professor of Hygiene and Microbiology Constantinos Savvas and the pediatrician Dr. Ioannis Kardamatis founded the Greek Anti-Malaria League. The League assumed a role that the State would not, and for the next 25 years organized the country's anti-malaria campaign. During its first steps, the Greek Anti-Malaria League adopted the principles of Professor Angelo Celli's Italian Anti-Malaria League. The League's accomplishments include a decrease in malarial prevalence, due to mass treatment with quinine, new legislation ensuring the provision of quinine, State monopoly and the collection of epidemiologic data. However, defeat in the Greek-Turkish War (1922) and the massive influx of one million Greek refugees that ensued, led to a change in malarial epidemiology. In 1928, following a visit to Italy, the Greek League adopted the organization and knowledge of the Italian Malaria Schools in Rome and in Nettuno, and this experience served as the basis of their proposal to the State for the development of the anti-malaria services infrastructure. The State adopted many of Professor Savvas' proposals and modified his plan according to Greek needs. The League's experience, accumulated during its 25 years of struggle against malaria, was its legacy to the campaigns that eventually accomplished the eradication of malaria from Greece after World War II.

Folk medicine used to heal malaria in Calabria (southern Italy).

In Italy, malaria was an endemic disease that was eradicated by the mid-20th century. This paper evaluates the prophylactic and therapeutic remedies used by folk medicine to cure malaria in Calabria (southern Italy).The data has been collected by analysing works of physicians, ethnographers, folklorists and specialists of the study of Calabrian history between the end of the 19th century and the 20th century. The data collected have allowed us to describe the most common cures used by the Calabrian people to treat malaria and the most evident symptoms of this disease, such as intermittent fever, hepato-spleenomegaly, asthenia and dropsy. This approach uncovered a heterogeneous corpus of empirical, magical and religious remedies, which the authors have investigated as evidences of past "expert medicine" and to verify their real effectiveness in the treatment of malaria.

Enfermidades endêmicas da capitania de Mato Grosso: a memória de Alexandre Rodrigues Ferreira / Endemic diseases of the captainship of Mato Grosso: the memory of Alexandre Rodrigues Ferreira

Evidencia como Alexandre Rodrigues Ferreira reuniu saberes das mais diferentes procedências. De fato, ao descrever doenças e curas, ele recorreu não apenas aos doutores e à medicina tradicional do Velho Mundo, mas valeu-se dos ensinamentos locais, de histórias contadas por oradores, do conhecimento indígena e de manuscritos, entregues ao doutor naturalista por curiosos, boticários e cirurgiões. Recorreu às diversas notícias, Ferreira tornou possível analisar as enfermidades e suas curas com base tanto no universo erudito europeu quanto no conhecimento tramado nos sertões americanos. A vivência nos trópicos, na úmida e colorenta capitania do Mato Grosso, demonstrou a necessidade de renovar a medicina, adaptá-la a um meio natural totalmente diverso. Para tanto, o naturalista, não concebeu hierarquia entre saberes, pois do contrário jamais apresentaria juntas as curas européias e americanas. Esta obra é a reprodução do manuscrito sobre a transcrição da memória 'Enfermidades endêmicas da capitania de Mato Grosso', elaborada provávelmente em 1791, pelo naturalista, depositado na Biblioteca Nacional do Rio de Janeiro, com sua grafia original, sem a adição de notas ou estudo introdutório (AU)

[A history of Malaria from and for a popular point of view]. / La Malaria, ossia la mal'aria: brevi note di una storia sociale e popolare.

The author outlines parasitologic features of human plasmodia and Anopheles, the public health and human aspects of this protozoan infection. Starting from the etymology of the words "mal' aria," the author describes a brief but proven history of social importance, dwelling not only on the clinical, medical or scientific aspects. In other words, the author dwells upon the literary, the customary, as well as on the historic and cultural aspects, with special attention to the significance of the popular importance of this problem in Italy.

O passado revisitado: o Instituto de Malariologia e o Instituto de Endemias Rurais (INERu) / The past revisited: the Institute of Malariology and the Institute of Rural Endemics

Conferência do engenheiro químico dr. Ernest Paulini sobre sua trajetória profissional no campo da malariologia e da saúde pública, em particular sobre o Instituto de Malariologia, realizada no Centro de Pesquisas René Rachou, em 6.12.2002, Belo Horizonte (MG). (AU)

A produçäo do conhecimento científico e as políticas de saúde pública: reflexöes a partir da ocorrência da filariose na cidade do Recife, Pernambuco, Brasil / Scientific knowledge and public health policies: reflections on the occurrence of filariasis in Recife, Pernambuco, Brazil

Discute a relaçäo entre a produçäo científica sobre a ocorrência da filariose bancroftiana no Brasil e o processo de formulaçäo e implementaçäo da política de saúde voltada ao seu controle. Para tanto, realiza uma revisäo da produçäo do conhecimento e das políticas específicas, no período compreendido desde a criaçäo do Programa de Combate à Filariose, em meados do século passado, até a criaçäo do SUS, no marco da descentralizaçäo do controle das endemias. (AU)

Assuntos científicos no Patriota - temática médica: doenças endêmicas e epidêmicas / Scientifical issues in the Patriota - medical topics: endemic diseases and epidemics

Descreve o texto denominado `Proposta da Câmara do Rio de Janeiro sobre doenças endêmicas e epidêmicas da mesma cidade`, publicado no jornal O Patriota, comentando as respostas que eram dadas pelos médicos, em sequência ao texto.(MAM)

Poder, ideologias e saúde no Brasil da primeira república: ensaio de sociologia histórica / Power, ideology and health in Brazil of the first republic: essay on historical sociology

Relata e propöe algumas hipóteses para o sentido que tomou a reforma sanitária no país, isto é, para seu caráter geograficamente diversificado e para sua impregnaçäo fortemente ideológica durante a Primeira República. (AU)

Tropical medicine, world diseases

It approaches the distinctive tropical medicine that arose in the last third of the nineteenth century, supplanting the traditional ´medicine of warm climates´.(AU)

[The places of Mal'aria and the causes of malaria]. / I luoghi della mal'aria e le cause della malaria.

According to the Hippocratic medicine remittent and intermittent fevers were caused by bad air (mal'aria) and bad water of marshes, which produced miasmata affecting people living near these environments. This wrong theory was remarkably stable and persistent until the end of the last century, being in fact quite adequate to decribe the epidemiology of malaria in Mediterranean areas, where the transmission of the parasite depended on mosquitoes breeding mainly in marsh ecosystems. The theory was even reinforced with the spreading of severe malaria due to Plasmodium falciparum (more closely associated with warm marshy areas) and when a specific remedy, quinine, came into the picture, improving the distinction of malaria from other fever diseases. After the discovery of the true causes of malaria infection and transmission, scientific medicine developed completely new definitions of malarious environments based on their stratification in terms of transmission risk and several parameters were introduced which provide a measure of the vectorial capacity. This paper focus on the most relevant historical events that have brought to the present knowledge of malarious environments, examining at the same time the effectiveness and limits of the Hippocratic view on the etiology of malaria.