African-led study delivers one of the largest microbiome feedback initiatives

Excellent science should not only generate new discoveries but ensure that trial participants who make these discoveries possible share in the benefits.

Researchers developed and evaluated the feedback initiative, returning gut microbiome results from a landmark microbiome study to 778 women involved in South Africa and Kenya.

The results came from the AWI-Gen 2 study published in Nature, which was the largest

population-representative survey of African gut metagenomes conducted to date.

The study substantially expanded global knowledge of African gut microbiomes, identifying         1 005 bacterial genomes not represented in existing reference collections, and showing how geography, lifestyle, and health shape microbiome composition.

Now, a linked study, Participant engagement and feedback in microbiome projects: a case of AWI-Gen2, revealed what happened when researchers returned individual microbiome research reports to study participants.

By developing culturally appropriate educational materials and conducting face-to-face feedback sessions in local languages, researchers were able to explain participants’ gut microbiome profiles.

Microbiome studies rarely return individualised results to participants in low-resource settings because interpreting highly technical information in ways that are appropriate, ethical and comprehensible is costly and complex. This gap, however, risks eroding trust among the people who contribute to research and consequently could diminish its long-term impact.

The latest study was published in mSystems, a journal of the American Society for Microbiology (ASM) and embedded within the larger Africa Wits-INDEPTH partnership (AWI-Gen). The study was led by researchers from the Sydney Brenner Institute for Molecular Bioscience (SBIMB) at Wits University, the  SAMRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), SAMRC/Wits Ageing African Adult Research Unit (A3RU), and collaborators at the African Population and Health Research Centre (Kenya) and Stanford University (USA). 

Importantly, their work moves participant engagement beyond consultation by demonstrating that returning microbiome findings can be embedded as a routine component of microbiome research.

Participants overwhelmingly welcomed receiving their results, saying the information improved their understanding of gut health and strengthened their trust in the research process. Some also said it encouraged them to consider healthier dietary choices, including eating more fibre-rich foods.

“Our findings demonstrate that even highly complex scientific information can be shared effectively when researchers work closely with communities and adapt communication to local cultural contexts,” said co-first author and researcher Dr Luicer Olubayo at the SBIMB.

Research participants received information on their gut microbial diversity, comparisons with community averages, and the relationship between diet, lifestyle and gut health. The team also evaluated participants’ understanding of the information, the impact of the feedback, and their perceptions of receiving personalised results.

Co-first author Dr Claudine Nkera-Gutabara of A3RU added: “The study shows that participants value receiving personalised research results, and that returning those results can strengthen relationships between researchers and communities while promoting a more inclusive and equitable research process.”  

This return-of-results project was initiated by  Dr Dylan Maghini, then a joint Wits/Stanford postdoctoral fellow at the SBIMB and the laboratory of Dr Ami Bhatt at Stanford University.

The study also complements a Nature Microbiology perspective by Dr Luicer Olubayo and SBIMB senior scientist, Professor Scott Hazelhurst, which reiterates the growing recognition that participant engagement and the return of research results should be considered integral components of microbiome and genomic research rather than optional additions.

“Beyond demonstrating participant acceptability, the study offers a practical framework for integrating participant engagement and the return of research results into the methodology of future microbiome and genomic studies,” said Professor Michèle Ramsay, Director of the SBIMB.

Key Takeaways

• The Agincourt and A3RU communities were central to the research. The Wits units’ decades-long relationship with communities helped researchers deliver results in trusted, locally relevant ways, demonstrating the value of sustained community partnerships.
• Returning results builds trust—and educational messages inspire healthier choices. Participants overwhelmingly welcomed receiving their individual microbiome reports and the accompanying information, and some expressed intentions to improve their diets by eating more fibre-rich foods. The study supports the view that returning results is an important ethical practice that can encourage healthier behaviours.
• Putting African communities at the centre of global science. The research demonstrates that scientific excellence is about more than generating world-class discoveries; participants should also benefit from the knowledge they help create.
• The study adds weight to an African-led model for microbiome research that combines cutting-edge science with meaningful community engagement, reciprocity and ethical research practice.
• A practical model for future microbiome and genomic research. The study provides a large-scale demonstrations that personalised microbiome results can be returned ethically, effectively and cost-efficiently in African research settings, supporting a broader shift towards embedding participant engagement as a core component of research practice
• The return-of-results project was funded by the Fogarty International Center of the United States National Institutes of Health.