Microbiome & infection inequities

Subtitle: a series of sickening facts

I’m interested in the role of the gut microbiome in infection, especially in settings with a high burden of infectious diseases. Therefore, I did a literature search on PubMed (full text of the search here).

The search returned a total of 47 papers. What proportion do you think were investigating charismatic animals like primates or rhinos, rather than humans? (link to twitter question)

The answer is 23% !!!!

This answer made me feel physically sick! There’s this exciting new(ish) field of the microbiome. One of the main roles of the microbiome is colonisation resistance to infections. There are billions of people in the world living in countries with a high burden of infectious diseases, and yet 23% of the research we’ve done on this issue in these countries is dedicated to animals?

Don’t get me wrong, I like primates and rhinos as much as the next person, but this seems like a gross imbalance. It’s unimaginable that in e.g the UK 23% of microbiome research related to infection would be done on hedgehogs and badgers, as opposed to on diabetes, cancer and obesity.

It reminds me of this quote from Everything Good Will Come by Sefi Atta:

Also, if we limit ourselves to just Africa, rather than including high infectious disease burden countries (HIDCs) from other continents, then the proportion would be even higher because most of the animal studies were from Africa, and a lot of the human studies were from e.g. India.

On top of this, there is the slightly more predictable imbalance between the high infectious disease burden countries and the non-high infectious disease burden countries – rough numbers of 47 for the HIDC and 3861 for the whole world (including the HIDCs). An 82:1 ratio! And this is searching just for infection papers, not obesity, diabetes etc! Search for the non-HIDCs was ((microbiome[Title/Abstract]) AND (infection[Title/Abstract] or colonisation resistance [Title/Abstract])) NOT (review[Publication Type]). The 47 and 3861 numbers are very approximate, as they will include some irrelevant research as well that just happens to hit the keywords.

If we then compare the sum of DALYs lost to infectious disease per 100,000 people per year in HIDCs to non-HIDCs, it’s about 4:1 HIDC:non-HIDC, so this 82:1 ratio becomes a 328:1 ratio if we think about papers “per DALY” of infectious diseases.


2 thoughts on “Microbiome & infection inequities

  1. Agree with the sentiment, but people tend to do research within their area of expertise. Doesn’t it seem likely that animal research has been carried out by vets and animal health groups who may not have the skills, expertise, patient access, or ethical framework available to conduct human research? Rather, perhaps this highlights the small total number of studies in this space that enables niche veterinary research to be so prominent.

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