Objective and materials

This research evaluates the presence and chronology of tuberculosis (TB) in the northeastern highlands of Peru (CE 800–1535) through the analysis of osseous lesions from Pre-Contact Kuelap, Chachapoyas.

Methods

We examined macroscopic lesion morphology and distribution from the skeletal series (MNI = 207).

Results

We determined that skeletal evidence was highly consistent with advanced multifocal and spinal tuberculosis in 13 individuals. Destructive lesions of the lower thoracic and/or lumbar vertebra bodies and sacroiliac joints are evident in most cases, but we also observed lesions within the manubriosternal, hip, and knee joints. Both adult males (n = 7) and females (n = 6) present skeletal lesions from young adult to older adults, but there is only one late adolescent. Only three individuals demonstrate similar lesion distributions.

Conclusions

Variation in lesion distribution in this population-based study shows the importance of identifying extra-vertebral tuberculosis and suggests that the disease may have manifested differently than at other coastal sites. These cases confirm the presence of tuberculosis both before and after Inca occupation across this central Andean highlands region.

Significance

This evidence for the likely endemic presence of TB in the New World prior to European Contact furthers our understanding of the distribution of this infectious disease across the region as well as elucidating lesion distribution.

Limitations

The diagnosis of tuberculosis is based on skeletal lesions and it should be confirmed by molecular analysis.

Future Research

Additional examination of vertebral bodies (including juvenile remains) for evidence of earlier manifestations of infection.

中文翻译：

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检查来自秘鲁东部山区的晚期接触前人群中骨骼结核的变异。

目标和材料

本研究通过分析来自查查波亚斯的 Pre-Contact Kuelap 的骨病变，评估了秘鲁东北部高地（公元 800-1535 年）结核病 (TB) 的存在和时间顺序。

方法

我们检查了骨骼系列的宏观病变形态和分布（MNI = 207）。

结果

我们确定骨骼证据与 13 名个体的晚期多灶性和脊柱结核高度一致。在大多数情况下，下胸椎和/或腰椎体和骶髂关节的破坏性病变很明显，但我们也观察到手骨、髋关节和膝关节内的病变。成年男性 (n = 7) 和女性 (n = 6) 都存在从青年到老年人的骨骼病变，但只有一名晚期青少年。只有三个人表现出相似的病变分布。

结论

这项基于人群的研究中病变分布的变化表明了识别椎外结核的重要性，并表明该疾病的表现可能与其他沿海地区不同。这些病例证实了这个安第斯高原中部地区在印加人占领之前和之后都存在结核病。

意义

在欧洲接触之前，新世界可能流行结核病的这一证据进一步加深了我们对这种传染病在该地区的分布以及阐明病变分布的理解。

限制

结核病的诊断基于骨骼病变，应通过分子分析确诊。

未来研究

额外检查椎体（包括幼年遗骸）以寻找早期感染表现的证据。