Marcel Tanner

Swiss Tropical and Public Health Institute, Bâle, Basel-City, Switzerland

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Publications (537)2234.11 Total impact

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    ABSTRACT: The malaria vaccine RTS,S induces antibodies against the Plasmodium falciparum circumsporozoite protein (CSP) and the concentration of Immunoglobulin G (IgG) against the repeat region of CSP following vaccination is associated with protection from P. falciparum malaria. So far, only the quantity of anti-CSP IgG has been measured and used to predict vaccination success, although quality (measured as avidity) of the antigen-antibody interaction shall be important since only a few sporozoites circulate for a short time after an infectious mosquito bite, likely requiring fast and strong binding. Quantity and avidity of anti-CSP IgG in African infants who received RTS,S/AS01E in a 0-1-2-month or a 0-1-7-month schedule in a phase 2 clinical trial were measured by enzyme-linked immunosorbent assay. Antibody avidity was defined as the proportion of IgG able to bind in the presence of a chaotropic agent (avidity index). The effect of CSP-specific IgG concentration and avidity on protective efficacy was modelled using Cox proportional hazards. After the third dose, quantity and avidity were similar between the two vaccination schedules. IgG avidity after the last vaccine injection was not associated with protection, whereas the change in avidity following second and third RTS,S/AS01E injection was associated with a 54% risk reduction of getting malaria (hazard ratio: 0.46; 95% confidence interval (CI): 0.22-0.99) in those participants with a change in avidity above the median. The change in anti-CSP IgG concentration following second and third injection was associated with a 77% risk reduction of getting malaria (hazard ratio: 0.23, 95% CI: 0.11-0.51). Change in IgG response between vaccine doses merits further evaluation as a surrogate marker for RTS,S efficacy. Identifier NCT00436007 .
    Malaria Journal 12/2015; 14(1). DOI:10.1186/s12936-015-0605-7 · 3.49 Impact Factor
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    ABSTRACT: To review current and emerging tools for Gambiense HAT control and elimination, and propose strategies that integrate these tools with epidemiological evidence. We reviewed the scientific literature to identify contemporary and emerging tools and strategies for controlling and eliminating Gambiense HAT. Through an iterative process involving key stakeholders, we then developed comprehensive scenarios leading to elimination, considering both established and new tools for diagnosis, case treatment and vector control. Core components of all scenarios include detecting and treating cases with established or emerging techniques. Relatively more intensive scenarios incorporate vector control. New tools considered include tiny targets for tsetse fly control, use of rapid diagnostic tests and oral treatment with fexinidazole or oxaboroles. Scenarios consider the time when critical new tools are expected to become ready for deployment by national control programmes. Based on a review of the latest epidemiological data, we estimate the various interventions to cover 1,380,600 km(2) and 56,986,000 people. A number of new tools will fill critical gaps in the current armamentarium for diagnosing and treating Gambiense HAT. Deploying these tools in endemic areas will facilitate the comprehensive and sustainable control of the disease considerably, and contribute to the ultimate goal of elimination. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Tropical Medicine & International Health 02/2015; DOI:10.1111/tmi.12483 · 2.30 Impact Factor
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    ABSTRACT: Background Around 3.3 million children worldwide are infected with HIV and 90% of them live in sub-Saharan Africa. Our study aimed to estimate adherence levels and find the determinants, facilitators and barriers of ART adherence among children and teenagers in rural Tanzania.Methods We applied a sequential explanatory mixed method design targeting children and teenagers aged 2¿19 years residing in Ifakara. We conducted a quantitative cross sectional study followed by a qualitative study combining focus group discussions (FGDs) and in-depth interviews (IDIs). We used pill count to measure adherence and defined optimal adherence as¿>¿=80% of pills being taken. We analysed determinants of poor adherence using logistic regression. We held eight FGDs with adolescent boys and girls on ART and with caretakers. We further explored issues emerging in the FGDs in four in-depth interviews with patients and health workers. Qualitative data was analysed using thematic content analysis.ResultsOut of 116 participants available for quantitative analysis, 70% had optimal adherence levels and the average adherence level was 84%. Living with a non-parent caretaker predicted poor adherence status. From the qualitative component, unfavorable school environment, timing of the morning ART dose, treatment longevity, being unaware of HIV status, non-parental (biological) care, preference for traditional medicine (herbs) and forgetfulness were seen to be barriers for optimal adherence.Conclusion The study has highlighted specific challenges in ART adherence faced by children and teenagers. Having a biological parent as a caretaker remains a key determinant of adherence among children and teenagers. To achieve optimal adherence, strategies targeting the caretakers, the school environment, and the health system need to be designed.
    BMC Infectious Diseases 01/2015; 15(1):28. DOI:10.1186/s12879-015-0753-y · 2.56 Impact Factor
  • One Health: The Theory and Practice of Integrated Health Approaches, Edited by Jakob Zinsstag, Esther Schelling, David Waltner-Toews, Maxine Whittaker, Marcel Tanner, 01/2015: chapter 9; CAB international.
  • One Health: The Theory and Practice of Integrated Health Approaches, Edited by Jakob Zinsstag, Esther Schelling, David Waltner-Toews, Maxine Whittaker, Marcel Tanner, 01/2015: chapter 27; CAB International.
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    ABSTRACT: Two long synthetic peptides representing the dimorphic and constant C-terminal domains of the two allelic families of Plasmodium falciparum merozoite surface proteins 2 are considered promising malaria vaccine candidates. The aim of the current study is to characterize the immune response (epitope mapping) in naturally exposed individuals and relate immune responses to the risk of clinical malaria. To optimize their construction, the fine specificity of human serum antibodies from donors of different age, sex and living in four distinct endemic regions was determined in ELISA by using overlapping 20 mer peptides covering the two domains. Immune purified antibodies were used in Western blot and immunofluorescence assay to recognize native parasite derivate proteins. Immunodominant epitopes were characterized, and their distribution was similar irrespective of geographic origin, age group and gender. Acquisition of a 3D7 family and constant region-specific immune response and antibody avidity maturation occur early in life while a longer period is needed for the corresponding FC27 family response. In addition, the antibody response to individual epitopes within the 3D7 family-specific region contributes to protection from malaria infection with different statistical weight. It is also illustrated that affinity-purified antibodies against the dimorphic or constant regions recognized homologous and heterologous parasites in immunofluorescence and homologous and heterologous MSP2 and other polypeptides in Western blot. Data from this current study may contribute to a development of MSP2 vaccine candidates based on conserved and dimorphic regions thus bypassing the complexity of vaccine development related to the polymorphism of full-length MSP2.
    Malaria Journal 12/2014; 13(1):510. DOI:10.1186/1475-2875-13-510 · 3.49 Impact Factor
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    ABSTRACT: Background There is a paucity of data pertaining to the epidemiology and public health impact of Enterobius vermicularis and Strongyloides stercoralis infections. We aimed to determine the extent of enterobiasis, strongyloidiasis, and other helminth infections and their association with asymptomatic Plasmodium parasitaemia, anaemia, nutritional status, and blood cell counts in infants, preschool-aged (PSAC), and school-aged children (SAC) from rural coastal Tanzania.MethodsA total of 1,033 children were included in a cross-sectional study implemented in the Bagamoyo district in 2011/2012. Faecal samples were examined for intestinal helminth infections using a broad set of quality controlled methods. Finger-prick blood samples were subjected to filariasis and Plasmodium parasitaemia testing and full blood cell count examination. Weight, length/height, and/or mid-upper arm circumference were measured and the nutritional status determined in accordance with age.Results E. vermicularis infections were found in 4.2% of infants, 16.7%, of PSAC, and 26.3% of SAC. S. stercoralis infections were detected in 5.8%, 7.5%, and 7.1% of infants, PSAC, and SAC, respectively. Multivariable regression analyses revealed higher odds of enterobiasis in children of all age-groups with a reported anthelminthic treatment history over the past six months (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.22 - 3.79) and in SAC with a higher temperature (OR: 2.21; CI: 1.13 - 4.33). Strongyloidiasis was associated with eosinophilia (OR: 2.04; CI: 1.20-3.48) and with Trichuris trichiura infections (OR: 4.13; CI: 1.04-16.52) in children of all age-groups, and with asymptomatic Plasmodium parasitaemia (OR: 13.03; CI: 1.34 - 127.23) in infants. None of the investigated helminthiases impacted significantly on the nutritional status and anaemia, but moderate asymptomatic Plasmodium parasitaemia was a strong predictor for anaemia in children aged older than two years (OR: 2.69; 95% CI: 1.23 ¿ 5.86).Conclusions E. vermicularis and S. stercoralis infections were moderately prevalent in children from rural coastal Tanzania. Our data can contribute to inform yet missing global burden of disease and prevalence estimates for strongyloidiasis and enterobiasis. The association between S stercoralis and asymptomatic Plasmodium parasitaemia found here warrants further comprehensive investigations.
    BMC Infectious Diseases 12/2014; 14(1):644. DOI:10.1186/s12879-014-0644-7 · 2.56 Impact Factor
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    ABSTRACT: The Taabo Health and Demographic Surveillance System (HDSS) is located in south-central Côte d’Ivoire, approximately 150 km north-west of Abidjan. The Taabo HDSS started surveillance activities in early 2009 and the man-made Lake Taabo is a key eco-epidemiological feature. Since inception, there has been a strong interest in research and integrated control of water-associated diseases such as schistosomiasis and malaria. The Taabo HDSS has generated setting-specific evidence on the impact of targeted interventions against malaria, schistosomiasis and other neglected tropical diseases. The Taabo HDSS consists of a small town, 13 villages and over 100 hamlets. At the end of 2013, a total population of 42 480 inhabitants drawn from 6707 households was under surveillance. Verbal autopsies have been conducted to determine causes of death. Repeated cross-sectional epidemiological surveys on approximately 5–7% of the population and specific, layered-on haematological, parasitological and questionnaire surveys have been conducted. The Taabo HDSS provides a database for surveys, facilitates interdisciplinary research, as well as surveillance, and provides a platform for the evaluation of health interventions. Requests to collaborate and to access data are welcome and should be addressed to the secretariat of the Centre Suisse de Recherches Scientifiques en Côte d’Ivoire: [].
    International Journal of Epidemiology 11/2014; DOI:10.1093/ije/dyu221 · 9.20 Impact Factor
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    ABSTRACT: Because most deaths in Africa and Asia are not well documented, estimates of mortality are often made using scanty data. The INDEPTH Network works to alleviate this problem by collating detailed individual data from defined Health and Demographic Surveillance sites. By registering all deaths over time and carrying out verbal autopsies to determine cause of death across many such sites, using standardised methods, the Network seeks to generate population-based mortality statistics that are not otherwise available.
    Global Health Action 10/2014; 7:25362. DOI:10.3402/gha.v7.25362 · 1.65 Impact Factor
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    ABSTRACT: The presentation of the World Health Organization (WHO)'s Roadmap for neglected tropical diseases (NTDs) in January 2012 raised optimism that many NTDs can indeed be eliminated. To make this happen, the endemic, often low-income countries with still heavy NTD burdens must substantially strengthen their health systems. In particular, they need not only to apply validated, highly sensitive diagnostic tools and sustainable effective control approaches for treatment and transmission control, but also to participate in the development and use of surveillance-response schemes to ensure that progress made also is consolidated and sustained. Surveillance followed-up by public health actions consisting of response packages tailored to interruption of transmission in different settings will help to effectively achieve the disease control/elimination goals by 2020, as anticipated by the WHO Roadmap. Risk-mapping geared at detection of transmission hotspots by means of geospatial and other dynamic approaches facilitates decision-making at the technical as well as the political level. Surveillance should thus be conceived and developed as an intervention approach and at the same time function as an early warning system for the potential re-emergence of endemic infections as well as for new, rapidly spread epidemics and pandemics.
    Acta Tropica 10/2014; 141. DOI:10.1016/j.actatropica.2014.09.017 · 2.52 Impact Factor
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    ABSTRACT: Background In the past decade, decreases in clinical episodes and deaths due to malaria have been mainly associated with the expansion of vector-control measures, such as insecticide-treated bednets and indoor residual spraying. Malaria indicator surveys gather information about key malaria indicators through national representative household surveys. We aimed to estimate changes in risk of malaria parasitaemia at high spatial resolution in sub-Saharan Africa, and to quantify the effects of malaria interventions at national and subnational levels. Methods In this spatial and temporal analysis, we analysed data from the six sub-Saharan countries that had publicly available data from two malaria indicator or demographic and health surveys with malaria measurements done in 2006–08 and 2010–12: Angola, Liberia, Mozambique, Senegal, Rwanda, and Tanzania. We used Bayesian geostatistical models to estimate the present malaria risk and to establish the change relative to the period between the last two national surveys. We applied Bayesian variable selection procedures to select the most relevant insecticide-treated-bednet measure for reducing malaria risk, and did spatial kriging over the study region to produce intervention coverage maps. We estimated the contribution of bednets and indoor residual spraying on changes in malaria risk, after adjustment for climatic and socioeconomic factors. Spatially varying coefficients of intervention coverage enabled estimation of their effects at subnational level. Findings In all countries, the probability of decrease in parasitaemia varied substantially between regions. Insecticide-treated bednets were an important intervention for reducing malaria risk, according to different definitions of coverage. An overall effect of insecticide-treated bednets at country level was significant only in Angola (–0·64, 95% credible interval −0·98 to −0·30) and Senegal (–0·34, −0·64 to −0·05); however, in all countries, we detected significant effects of bednets and indoor residual spraying at local level. Interpretation The described methodology is useful for the identification of regions where changes in malaria risk have taken place, and to describe the geographical pattern of malaria. Intervention effects vary in space, which might be driven by local endemicity levels. The produced maps provide a visual aid for national malaria control programmes to identify where targeted strategies and resources are most needed or likely to have the greatest effect on reducing the risk of parasitaemia. Funding Swiss Programme for Research on Global Issues for Development.
    10/2014; 2(10):e601–e615. DOI:10.1016/S2214-109X(14)70300-6
  • 08/2014; DOI:10.4000/vertigo.14976
  • 08/2014; DOI:10.4000/vertigo.14999
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    ABSTRACT: Hypothermia contributes to neonatal morbidity and mortality in low-income countries, yet little is known about thermal care practices in rural African settings. We assessed adoption and community acceptability of recommended thermal care practices in rural Tanzania.
    BMC Pregnancy and Childbirth 08/2014; 14(1):267. DOI:10.1186/1471-2393-14-267 · 2.15 Impact Factor
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    ABSTRACT: Abstract Background:A malaria vaccine could be an important addition to current control strategies. We report the safety and vaccine efficacy (VE) of the RTS,S/AS01 vaccine during 18 mo following vaccination at 11 African sites with varying malaria transmission. Methods and Findings:6,537 infants aged 6–12 wk and 8,923 children aged 5–17 mo were randomized to receive three doses of RTS,S/AS01 or comparator vaccine. VE against clinical malaria in children during the 18 mo after vaccine dose 3 (per protocol) was 46% (95% CI 42% to 50%) (range 40% to 77%; VE, p,0.01 across all sites). VE during the 20 mo after vaccine dose 1 (intention to treat [ITT]) was 45% (95% CI 41% to 49%). VE against severe malaria, malaria hospitalization, and all-cause hospitalization was 34% (95% CI 15% to 48%), 41% (95% CI 30% to 50%), and 19% (95% CI 11% to 27%), respectively (ITT). VE against clinical malaria in infants was 27% (95% CI 20% to 32%, per protocol; 27% [95% CI 21% to 33%], ITT), with no significant protection against severe malaria, malaria hospitalization, or all-cause hospitalization. Postvaccination anti-circumsporozoite antibody geometric mean titer varied from 348 to 787 EU/ml across sites in children and from 117 to 335 EU/ml in infants (per protocol). VE waned over time in both age categories (Schoenfeld residualsp,0.001). The number of clinical and severe malaria cases averted per 1,000 children vaccinated ranged across sites from 37 to 2,365 and from21 to 49, respectively; corresponding ranges among infants were210 to 1,402 and213 to 37, respectively (ITT). Meningitis was reported as a serious adverse event in 16/5,949 and 1/2,974 children and in 9/4,358 and 3/2,179 infants in the RTS,S/AS01 and control groups, respectively. Conclusions:RTS,S/AS01 prevented many cases of clinical and severe malaria over the 18 mo after vaccine dose 3, with the highest impact in areas with the greatest malaria incidence. VE was higher in children than in infants, but even at modest levels of VE, the number of malaria cases averted was substantial. RTS,S/AS01 could be an important addition to current malaria control in Africa. Trial registration: NCT00866619 Please see later in the article for the Editors’ Summary
    PLoS Medicine 07/2014; 11(7). DOI:10.1371/journal.pmed.1001685 · 14.00 Impact Factor
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    ABSTRACT: Controlled human malaria infection (CHMI) by mosquito bite has been used to assess new anti-malaria interventions in > 1,500 volunteers since development of methods for infecting mosquitoes by feeding on Plasmodium falciparum (Pf) gametocyte cultures. Such CHMIs have never been used in Africa. Aseptic, purified, cryopreserved Pf sporozoites, PfSPZ Challenge, were used to infect Dutch volunteers by intradermal injection. We conducted a double-blind, placebo-controlled trial to assess safety and infectivity of PfSPZ Challenge in adult male Tanzanians. Volunteers were injected intradermally with 10,000 (N = 12) or 25,000 (N = 12) PfSPZ or normal saline (N = 6). PfSPZ Challenge was well tolerated and safe. Eleven of 12 and 10 of 11 subjects, who received 10,000 and 25,000 PfSPZ, developed parasitemia. In 10,000 versus 25,000 PfSPZ groups geometric mean days from injection to Pf positivity by thick blood film was 15.4 versus 13.5 (P = 0.023). Alpha-thalassemia heterozygosity had no apparent effect on infectivity. PfSPZ Challenge was safe, well tolerated, and infectious.
    The American journal of tropical medicine and hygiene 07/2014; DOI:10.4269/ajtmh.14-0119 · 2.74 Impact Factor
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    ABSTRACT: In Sub-Saharan Africa over one million newborns die annually. We developed a sustainable and scalable home-based counselling intervention for delivery by community volunteers in rural southern Tanzania to improve newborn care practices and survival. Here we report the effect on newborn care practices one year after full implementation.
    BMC Pediatrics 07/2014; 14(1):187. DOI:10.1186/1471-2431-14-187 · 1.92 Impact Factor
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    ABSTRACT: Sleeping under a net, particularly a long-lasting insecticidal net (LLIN), is associated with reduced malaria morbidity and mortality, but requires high coverage and adherence. In this study, parasitologically confirmed Plasmodium falciparum infection and a clinical indicator (i.e. fever) were measured among children in three villages of central Cote d'Ivoire (Bozi, N'Dakonankro and Yoho) and associations with net coverage explored. In Bozi and Yoho, LLINs were provided by the national malaria control programme, prior to the study and an additional catch-up coverage was carried out in Bozi. In N'Dakonankro, no net intervention was conducted.
    Parasites & Vectors 07/2014; 7(1):306. DOI:10.1186/1756-3305-7-306 · 3.25 Impact Factor
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    ABSTRACT: Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular.Case description: The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales.Discussion and evaluation: The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme.
    Malaria Journal 06/2014; 13(1):245. DOI:10.1186/1475-2875-13-245 · 3.49 Impact Factor
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    ABSTRACT: Non-communicable diseases dominate the public health arena in China, yet neglected tropical diseases (NTDs) are still widespread and create a substantial burden. We review the geographical distribution, prevalence, and epidemic characteristics of NTDs identified in China caused by helminths, protozoa, bacteria, and viruses. Lymphatic filariasis was eliminated in 2007, but schistosomiasis still affects up to 5% of local village residents in some endemic counties with around 300 000 people infected. China harbours more than 90% of the world's burden of alveolar echinococcosis and food-borne zoonoses are emerging. In 2010, the overall prevalence of soil-transmitted helminth infections caused by Ascaris lumbricoides, Trichuris trichiura, and hookworm was 11·4%, with 6·8% of these infections caused by A lumbricoides. Corresponding figures for food-borne trematodiasis, echinococcosis, and cysticercosis are more than 5%. Dengue, leishmaniasis, leprosy, rabies, and trachoma exist in many areas and should not be overlooked. Transmission of vector-borne diseases can be interrupted; nevertheless, epidemics occur in remote areas, creating a challenge for surveillance and control. Rigorous surveillance, followed by immediate and integrated response packages tailored to specific social and ecological systems, is essential for progress towards the elimination of NTDs in China.
    The Lancet Infectious Diseases 05/2014; 14(9). DOI:10.1016/S1473-3099(14)70727-3 · 19.45 Impact Factor

Publication Stats

16k Citations
2,234.11 Total Impact Points


  • 1982–2015
    • Swiss Tropical and Public Health Institute
      • Department of Epidemiology and Public Health
      Bâle, Basel-City, Switzerland
  • 2014
    • Umeå University
      Umeå, Västerbotten, Sweden
  • 2009–2014
    • Universität Basel
      • Swiss Tropical and Public Health Institute (Swiss TPH)
      Bâle, Basel-City, Switzerland
    • Institut de Formation et de Recherche Démographiques
      Jaúnde, Centre Region, Cameroon
  • 2013
    • Centro de Investigação em Saúde de Manhiça
      Lourenço Marques, Maputo City, Mozambique
  • 2009–2013
    • Ifakara Health Institute
      Dār es Salām, Dar es Salaam, Tanzania
  • 2003–2013
    • London School of Hygiene and Tropical Medicine
      • Faculty of Infectious and Tropical Diseases
      London, ENG, United Kingdom
  • 1999–2013
    • University of Queensland 
      • • School of Population Health
      • • Australian Centre for International and Tropical Health (ACITH)
      Brisbane, Queensland, Australia
    • Doctors Without Borders
      Lutetia Parisorum, Île-de-France, France
    • China Academy of Chinese Medical Sciences
      Peping, Beijing, China
  • 2011
    • University of Tuebingen
      • Department of Tropical Medicine
      Tübingen, Baden-Württemberg, Germany
    • Eawag: Das Wasserforschungs-Institut des ETH-Bereichs
      Duebendorf, Zurich, Switzerland
  • 2007–2011
    • Centre Suisse De Recherches Scientifiques En Côte D'Ivoire
      Abijan, Lagunes, Ivory Coast
    • University of Nebraska Medical Center
      • College of Pharmacy
      Omaha, Nebraska, United States
  • 2010
    • Liverpool School of Tropical Medicine
      Liverpool, England, United Kingdom
    • Institut National de Recherche en Santé Publique
      Nouakchot, Nouakchott, Mauritania
  • 2006
    • University of Barcelona
      Barcino, Catalonia, Spain
  • 2005–2006
    • Jiangsu Institute of Parasitic Diseases
      Wu-hsi, Jiangsu Sheng, China
  • 1997–2006
    • University of Zurich
      Zürich, Zurich, Switzerland
  • 2004
    • University of Cambridge
      • Department of Pathology
      Cambridge, ENG, United Kingdom
  • 2001–2004
    • Princeton University
      • Office of Population Research
      Princeton, New Jersey, United States
  • 2002
    • Chinese Center For Disease Control And Prevention
      Peping, Beijing, China
    • Yunnan Institute Of Parasitic Diseases
      白庙, Shaanxi, China
  • 1996–2002
    • Hospital Clínic de Barcelona
      Barcino, Catalonia, Spain
  • 2000
    • National Institute of Parasitic Diseases
      Shanghai, Shanghai Shi, China
    • Queensland Institute of Medical Research
      • Molecular Parasitology Laboratory
      Brisbane, Queensland, Australia
  • 1998
    • The University of Edinburgh
      • Institute of Cell Biology
      Edinburgh, Scotland, United Kingdom
  • 1990
    • Kantonsspital Liestal
      Liestal, Basel-Landschaft, Switzerland
  • 1986–1990
    • University of Geneva
      Genève, Geneva, Switzerland