Members of the Ivorian Red Cross and the International Committee of the Red Cross test a well following a chlorination campaign, via the ICRC's Flickr.
On the last day of the year, we've got a late entry for the title of most ridiculously titled paper of the year. Published in PLoS Neglected Tropical Diseases, it's a public health paper called “An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool.”
As you might have guessed, the study looks at methods for quantifying parasite load in the poop in residents of the Ivory Coast. Parasitic worms are an important health concerns, especially in regions with poor sanitation, and S. mansoni can produce schistosomiasis, a chronic illness that can affect the development of children.
The study is aimed at increasing the accuracy of medical treatment, and as such is deserving of coverage regardless of what it's called. But man, that title is awkward, and that’s coming from someone who’s both a fan of making poop jokes to raise awareness of sanitation issues, and a fan of swearing. Yet when the study essentially boils down to a look at effective methods of smearing smear stool samples–which is extremely valuable, mind you–I feel like the title of the paper is somewhat trollish. I mean, we’re talking about nasty health matters in impoverished tropical nations, whose economies have been held back by disease. Why frame things in a way that’s going to bait coverage laughing about how the scientists said shit?
First, let’s look at the study. For doctors, measuring egg counts in human stool is a key method for diagnosing infection as well as tracking the efficacy of treatment. But as the research team notes, “there is considerable intra- and inter-specimen variation of helminth egg counts in human feces.” In other words, parasitic worm eggs don’t spread themselves evenly through a person’s stool, which makes quantifying egg load. The team wrote that homogenization (in effect, mixing the stool sample up) has been suggested as a method for increasing the accuracy of samples.
In essence, it’s a study aimed at stool smearing techniques, which is why it features awesome figures like this one showing collection methods:
Credit: Krauth et al
The team sampled the stool of 222 rural Ivorians, and chopped up their logs into four segments in order to measure egg concentration across their stool. They actually rolled the samples into sausage shapes, and smeared samples via the Kato-Katz method (PDF).
Credit: Krauth et al
The team found “no clear spatial pattern of S. mansoni and hookworm eggs in fecal samples.” In other words, parasitic worm eggs don’t space themselves out in people’s stool in an orderly fashion, which shouldn’t come as much of a surprise. The team also found that, over time, hookworm eggs counts decreased, but that decrease was slowed when sampled were kept on ice or covered with a moist cloth.
As such, they suggest that, for more accurate egg counts, samples must be homogenized and kept cold. That’s an important finding, as accurate assessment of an infection is paramount when it comes to diagnosis and treatment.
But back to “An In-Depth Analysis of a Piece of Shit.” Personally, I find it hilarious, and I’m not surprised that researchers who discuss the minutiae of poo-smearing technique would also have a sense of humor about their work. That title has to be the driest bit of research humor I’ve seen this year.
At the same time, a title like that puts a lot of faith in how it’s going to be covered. Remember the kerfluffle earlier this year about the hyper-intelligent space dinosaurs? A researcher threw in a humorous aside in a paper about how space dinosaurs could exist, and a whole lot of journalists lost their shit hyping it. It was a terrible example of writers missing the science for the viral headline.
In this case, I’m going to guess, solely based off my experiences with people that deal with public health and sanitation–you know, the people who make legit poop jokes–that the researchers here were having a laugh. (I’d love to see how that title got past an editor, and reached out to PLoS for comment. I’ll update if and when they get back.)
Yet when there’s already plenty of bad coverage out there as it is, why would you want to invite people hyping your work for the headline rather than the actual public health implications? (I’m fully aware that I, having dedicated half of this piece discussing the title, am just as guilty.) From a more cynical standpoint, maybe it’s a response to the fact that a heck of a lot of science coverage is more or less rewritten press releases, and you’ve got to do something to stand out on Eurekalert.
In the end, the researchers are adults, and they can say “shit” whenever they want. I still think it comes off as more of an in-joke for parasite researchers. At the same time, are we at the point where swearing in research paper titles is the way to guarantee coverage? It’s certainly attention-grabbing, but I’d like to imagine that science should be able to stand on its own. Perhaps I’m just being too stodgy though. Shit, it is pretty damn funny.
Hat tip to Joe Hanson for sharing the paper.