ABSTRACT Thalassemia is an inherited blood disorder affecting hemoglobin synthesis that is common in the Mediterranean, Middle East, Indian subcontinent, and Southeast Asia. Skeletal evidence for the disease has been identified in Mainland Southeast Asia as early as 7000 years ago. Thalassemia results in hyperactive marrow expansion, increasing the brittleness of bone and leading to poorer preservation in the archaeological record. Thus, the disease is likely underdiagnosed in paleopathology. To obtain a more accurate prevalence of thalassemia in the past and to continuously develop metric data sets for identifying anemia, we propose using metric measurements of more fragmentary remains. Measurements were taken at 25 fuzzy landmarks of 23 nonadult crania at Man Bac (4000–3500 bp ) in Northern Vietnam. Results indicated that cranial measurements could be potentially beneficial in identifying cases of thalassemia, particularly for facial bones. Our research identified two new cases of thalassemia. We suggest that craniofacial metric analysis for the identification of thalassemia in fragmented nonadult remains appears valuable alongside careful review of the macroscopic and radiographic evidence for pathology. However, due to the small sample size, limited by age‐specific sampling, and the multilayered disease burdens at Man Bac, our method suggested here is exploratory only. Future research will apply the method in other archaeological contexts in Vietnam.
Tran et al. (2026) studied this question.