Hydatid disease (Echinococcosis granulosis) diagnosis from skeletal osteolytic lesions in an early seventh-millennium BP forager community from preagricultural northern Vietnam

OBJECTIVES

Con Co Ngua is a complex, sedentary forager site from northern Vietnam dating to the early seventh millennium BP. Prior research identified a calcified Echinococcus granulosis cyst, which causes hydatid disease. Osteolytic lesions consistent with hydatid disease were also present in this individual and others. Hydatid disease is observed in high frequencies in pastoralists, and its presence in a hunter-gatherer community raises questions regarding human-animal interaction prior to farming. The objective of this article is to identify and describe the epidemiology of hydatid disease in the human skeletal assemblage at Con Co Ngua.

MATERIALS AND METHODS

One hundred and fifty-five individuals were macroscopically assessed for lesions. Of these, eight individuals were radiographed. Hydatid disease was diagnosed using a new threshold criteria protocol derived from clinical literature, which prioritizes lesions specific to the parasite.

RESULTS

Twenty-two individuals (14.2%) presented with osteolytic lesions consistent with hydatid disease, affecting the distal humerus, proximal femur and forearm, and pelvis. Seven individuals radiographed (4.5%) had multilocular cystic lesions strongly diagnostic for hydatid disease. All probable cases had lesions of the distal humerus. The remaining lesions were macroscopically identical to those radiographed and were considered possible cases.

DISCUSSION

While hydatid disease has previously been found in pre-agricultural communities, the high prevalence at Con Co Ngua is non-incidental. We propose that the presence of wild canids and management of wild buffalo and deer increased the risk of disease transmission. These findings further reveal subsistence complexity among hunter-gatherers living millennia prior to the adoption of farming in Southeast Asia.

'New bottle, but old wine': from family planning to HIV/AIDS in post-Doi Moi Vietnam

This paper begins with an observation that during the past two decades HIV/AIDS has emerged as a new public health priority in Vietnam and has commanded increasing attention and resources from both the government and the donor community. By juxtaposing HIV/AIDS with family planning, another social and health priority that preceded, and overlapped with, HIV/AIDS for a large part of the 1990s, we show two major gaps that have undermined both programmes. One is the lack of a strong civil society, that could have served as advocates for change, especially outside the government and the donor community. The other is the desire for control of women's bodies and sexuality that has been driven by the ever shifting project of nation building. We argue that these two major gaps represent more continuity than discontinuity in the way sexual and reproductive health issues are approached in Vietnam despite the seeming shift in priority that the emergence of HIV/AIDS suggests.