How migration and conflict shape the vaginal microbiome: what we do and do not know

The Human Microbiome Project and subsequent human microbiome research have illuminated the role bacteria play in human health and disease. Yet, the vaginal microbiome remains understudied, particularly among displaced and refugee populations. Existing studies suggest that having multiple sex partners and limited access to clean water and menstrual products are risk factors for Bacterial Vaginosis (BV), the most common form of vaginal dysbiosis. Displaced women are regularly exposed to these risk factors and experience higher rates of other STIs such as syphilis, yet no literature measures BV prevalence or examines the role displacement plays in the vaginal microenvironment. We suggest uniting doctors and researchers to collect vaginal swabs in displaced communities. Each participant would be diagnosed and treated with BV using current gold-standard methods, and would have additional swabs used for Multi-omic analysis to help us gain a clearer understanding of how displacement impacts the vaginal microbiome at large. Joining these efforts would minimize work added for clinicians to conduct research as they would be collecting vaginal swabs already, and a study like this would provide opportunities to researchers in host countries. Understanding the impacts of displacement on the vaginal microbiome could lead to the development of cheaper and more specific diagnostics, making it possible for humanitarian groups to prioritize vaginal and women's health in their aid responses during crises.