Understanding_the_aetiology_of_genital_ulcer_and_the_genital_microbiome__MAGUS_M_
The Multi-Country Aetiology of Genital Ulcer Survey (MAGUS) was conducted between 2022 and 2024, and prospectively recruited over 1000 individuals across four countries (Botswana, Ghana, Uganda and Zimbabwe). MAGUS represents the most comprehensive surveillance effort for genital ulcers conducted in sub-Saharan Africa in the last decade, and implemented multiplex qPCR diagnostics for three aetiology agents: Herpes Simplex Virus, Treponema pallidum and Haemophilis ducreyi. However, findings showed a large proportion of symptomatic ulcers which were negative for all three agents. The proportion of negative samples varied by country, and it is unclear whether additional aetiological agents may explain these results. Moreover, the microbiome of genital ulcer is poorly studied, and these samples provide a unique resource for investigating this in the context of different pathogenic agents. In this study, we will perform deep shotgun metagenomics of genital ulcer DNA samples to both investigate the microbiome as well as the likely aetiological agents infecting individuals in the study. Metagenomic data will enable us to reconstruct genomes for high abundance taxa, and enable detection of low abundance taxa.