Application of a probabilistic approach to the diagnosis of tuberculosis in archaeological human remains: methodological aspects

Abstract

Introduction. Tuberculosis is a pressing public health issue caused primarily by Mycobacterium tuberculosis. Genetic data enables the reconstruction of the co-evolution of this pathogen and humans over tens of thousands of years. The analysis of tuberculosis in ancient human skeletal remains relies on specific osseous lesions, which are rarely formed. This scarcity stimulates the search for new diagnostic approaches. Recently, a probabilistic approach has been proposed. It utilizes non-specific skeletal features of the disease. Individually, these features have limited diagnostic value, but in combination, they can successfully identify the disease. Based on materials from certified collections previously examined by other researchers, ten indicators on the skull and postcranial skeleton have been identified as suitable for this purpose.

Materials and methods. A unified methodological procedure for recording nonspecific signs of tuberculosis and calculating the probability of the disease at both individual and group levels was tested using the Kozino anthropological series (14th–18th centuries), comprising 298 individuals. All statistical analyses were performed in the R environment using custom code developed by K. Yu. Kuprikova.

Results and discussion. This section describes the topography and criteria for recording Tuberculosis indicators and presents a step-by-step algorithm for calculating the Tau index, which estimates the probability of disease presence at both individual and group levels. The algorithm's performance was tested, and a statistical assessment of disease prevalence within the group was conducted, accounting for the model's quality. Twenty-seven individuals were identified with a Tau index suggesting a high probability of bone tuberculosis. Paleogenetic analysis confirmed the presence of the disease in these cases, validating the effectiveness of the proposed methodological approach.

Conclusion. The proposed set of osseous indicators, analyzed through a probabilistic approach, is a relevant tool for diagnosing tuberculosis in ancient skeletal remains. To further validate this methodology, future research should involve the collection of additional data for a direct comparison between diagnoses made using probabilistic approaches and those confirmed by paleogenetic analysis.

Acknowledgements. The study was conducted under the state assignment of Lomonosov Moscow State University.

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