Study title: Multi-Country Aetiology of Genital Ulcer Study

Lead Reasercher(s)

Rashida Ferrand

Funder(s)

 Bill and Melinda Gates Foundation

Partner(s)

Wellcome Sanger Institute, London School of Hygiene and Tropical Medicine, Zvitambo Institute for Maternal and Child Health Research, Bill and Melinda Foundation, Ministry of Health and Child Care

Background

The Multi-country Aetiology of Genital Ulcer Study (MAGUS) aims to determine the causes of genital ulcer diseases (GUD) and the genomic epidemiology of Treponema pallidum, the pathogen that causes syphilis. A deep understanding of genetic diversity of a pathogen is crucial for designing globally representative equitable vaccines and molecular diagnostics and for epidemiological surveillance.

There are major gaps in understanding genetic diversity of Treponema pallidum from much of the world for example in a recent global analysis of genomes, only 19 of the 726 genomes were from Africa. This project aims to address this gaps by collecting genomes of Treponema pallidum for whole genome sequencing and meta-genomics using established pipelines and partnerships

Study aim(s)

Determine the cause of genital ulcer disease across different countries in Africa.

Conduct whole genome sequencing on organisms identified in GUD cases to examine genomic diversity.

To establish a collaborative network for studies of genomic epidemiology of STIs in the African region.

Study design

The study is a multi-country cross-sectional study conducted in Botswana, Ghana, Uganda, and Zimbabwe. Participants aged 16 and older with genital ulcers will undergo an interviewer administered questionnaire and have swabs of the ulcer collected. Multiplex PCR testing will be performed on swabs to determine the cause of GUD and whole genome sequencing will be performed on T. pallidum genomes.

Sub-studies investigating the prevalence and spectrum of co-prevalent STIs and a qualitative study I to explore knowledge of STIs, attitudes towards STI testing, including facilitators and barriers, and preferences for testing methods are embedded within the project.

Study dates

2022-2024