MRC News - April 2002

Spotlight on the Genital Ulcer Research Unit

The MRC's Genital Ulcer Research Unit is based at the University of Natal and is directed by Prof. Wim Sturm. MRC News takes a look at their work.

Sexually transmitted diseases (STDs) might not be high on everybody's list of favourite dinnertime topics, but it's a major health problem that many South Africans live with. They are an important co-factor in the spread of HIV/AIDS - if you have an STD you'll be more likely to become infected with HIV.

According to Prof. Sturm, there are two major groups of STDs. "The first group is the discharge-type disease and the second is ulcerative disease. The ulcerative type disease in particular is linked to the transmission of HIV. This is a fact we didn't know when we first started the Unit," he explains.

Prof. Sturm keeps a watchful eye on one of his students.

During that time research mainly concentrated on the pathogenesis of the ulcers, in particular the chancroid. "But the goalposts have moved a bit due to HIV - as in the case of many diseases. At the moment we are investigating whether the immunological link is related to a combined action between the organisms that cause those ulcers and HIV, or whether it is just a matter of joint risk behaviour of people who have STDs," he says.

The main treatment for people with STDs is antibiotics - a treatment to which patients respond very well. However, many people fall prey to STDs repeatedly, without becoming immune. "This is also one of the research foci of the Unit - we try to understand the interaction between the microbes that cause the ulcerative disease and the human body," he says.

One of the original goals of the Unit was to try and work towards finding vaccines against STDs. Such a vaccine would then be administered to people before becoming sexually active. "But before you can find a vaccine, you must first understand why there is no natural immunity against the disease," Prof. Sturm voices.

Towards the end of this year the Unit will, in collaboration with the Africa Centre in Mtubatuba, work on an intervention study. This project will investigate what the impact on HIV transmission would be if a whole community is treated for STDs - this includes asymptomatic cases. "This will be huge - almost like a military exercise, and it must be done in a short period of time. If you take too long, the community will only be re-infecting each other again," he explains.

Prof. Sturm's work on Heamophilus ducreyi and Calymmatobacterium granulomatis is truly innovative. His team was the first research group in the world to culture C. granulomatis.