The Origins of Gibbon Ape Leukaemia Virus

Gibbon ape leukaemia virus (GALV) was first isolated in the early 1970s after a number of gibbons that were housed at the SEATO medical research in Bangkok, Thailand, were diagnosed with lymphoid tumours including malignant lymphoma. It is a novel gamma retrovirus that has never been isolated from wild gibbons. It appears that GALV occurred as a result of a species jump from another as yet unidentified vertebrate host. The full sequence of GALV suggests that it is related loosely to murine leukaemia viruses and a number of rodent species from Southeast Asia have been suggested as possible hosts of the ancestor to GALV. However, no proviral sequence from any Southeast Asian vertebrate has been so far isolated which could be a candidate virus. More recently, two closely related viruses have been found in koalas and a native Australian rat, the grassland melomys (Melomys burtoni). These are koala retrovirus (KoRV) and Melomys burtoni retrovirus (MbRV). A number of theories have been published recently which endeavour to explain the origins of GALV and its relationship to other viruses including KoRV. Here, the history of GALV is documented and the strengths and weaknesses of current theories on the origin of this virus are discussed

Party Halls in African Town: Case of Economic Capital of Burundi, Bujumbura.

This paper proposes a classification of some halls very modern in Bujumbura economic capital of Burundi. A survey whose target population is the set of individuals regularly participating in the various festivals in Bujumbura, the economic capital of Burundi was put into action. An analysis of the data and interpretation of the results is made. These results conclude that there is a visible lack of well-developed halls on international measures in Bujumbura

Pharmacovigilance data as a trigger to identify antimicrobial resistance and inappropriate use of antibiotics : A study using reports from the netherlands pharmacovigilance centre

Funding: J.M.V.H. was partially funded by the European & Developing Countries Clinical Trials Partnership (EDCTP) for this research; grant number: not applicable.(1) Background: Antimicrobial resistance (AMR) requires urgent multidisciplinary so-lutions, and pharmacovigilance has the potential to strengthen current antimicrobial stewardship strategies. This study aimed to characterize AMR-relevant adverse drug reaction (ADR) reports submitted to The Netherlands Pharmacovigilance Centre; (2) Methods: We carried out a descriptive analysis of ADR reports submitted to Lareb, coded with AMR-relevant MedDRA Preferred Terms (PTs); (3) Results: Between 1998 and January 2019, 252 AMR-relevant ADR reports were submitted to Lareb. The most frequent antibiotics were tobramycin (n = 89; 35%), colistin (n = 30; 11.9%), cipro-floxacin (n = 16; 6.3%), doxycycline (n = 14; 5.5%), and aztreonam (n = 12; 4.8%). The PTs used included off label use (n = 91; 36.1%), drug ineffective (n = 71; 28.2%), product use in unapproved indication (n = 28; 11.1%), pathogen resistance (n = 14; 5.6%), and drug resistance (n = 13; 5.2%). 54% of the reports were on Watch antibiotics and 19% were involved in the Reserve group. In the Watch group, "off label use" and "product use in unapproved indication" were the most frequent PTs and the majority of reports on Reserve antibiotics were coded as "Off label". A sharp increase in the number of reports was observed in the three consecutive years with 21 in 2013, 54 in 2014, and 83 in 2015; (4) Conclusions: In addition to existing AMR monitoring strategies, pharmacovigilance databases can serve as a source of data on suspected resistance and inappropriate use. Future research should explore how these AMR-relevant MedDRA Terms are used in resource-limited settings with less capacity to generate laboratory-confirmed resistance data

Hospital acquired infections in pediatrics unit at Butare University Teaching Hospital (CHUB)

Background: Hospital acquired infection (HAI) also called nosocomial infection is an infection acquired in hospital or other healthcare facilities. HAIs are a major public health problem all over the world, but particularly in developing nations and they are among the major causes of death and increased morbidity among hospitalized patients. It was found that HAI in sub-Saharan Africa is the major cause of illness and death in children.Aim: The aim of this study was to provide knowledge on the prevalence of hospital acquired infection in pediatric unit of the University Teaching Hospital of Butare (Rwanda).Methods: Hospital acquired infections surveillance method and definition of infections described by CDC/NHSN were used.Results and conclusion: This study showed that the prevalence of HAI was very high (12.1 %) and the main bacteria causing NIs in pediatric unit were Kleblesiela pneumonia, followed by E. coli and Staphylococcus aureus. Low Respiratory HAIs were the most prevalent.Keywords: Prevalence, Hospital Acquired infection, Pediatric

Extracellular DNAses Facilitate Antagonism and Coexistence in Bacterial Competitor-Sensing Interference Competition

Over the last 4 decades, the rate of discovery of novel antibiotics has decreased drastically, ending the era of fortuitous antibiotic discovery. A better understanding of the biology of bacteriogenic toxins potentially helps to prospect for new antibiotics. To initiate this line of research, we quantified antagonists from two different sites at two different depths of soil and found the relative number of antagonists to correlate with the bacterial load and carbon-to-nitrogen (C/N) ratio of the soil. Consecutive studies show the importance of antagonist interactions between soil isolates and the lack of a predicted role for nutrient availability and, therefore, support an in situ role in offense for the production of toxins in environments of high bacterial loads. In addition, the production of extracellular DNAses (exDNases) and the ability to antagonize correlate strongly. Using an in domum-developed probabilistic cellular automaton model, we studied the consequences of exDNase production for both coexistence and diversity within a dynamic equilibrium. Our model demonstrates that exDNase-producing isolates involved in amensal interactions act to stabilize a community, leading to increased coexistence within a competitor-sensing interference competition environment. Our results signify that the environmental and biological cues that control natural-product formation are important for understanding antagonism and community dynamics, structure, and function, permitting the development of directed searches and the use of these insights for drug discovery

Improving pediatric TB diagnosis in North Kivu (DR Congo), focusing on a clinical algorithm including targeted Xpert MTB/RIF on gastric aspirates

Background The incidence of tuberculosis (TB) in the Democratic Republic of the Congo (DRC) is 323/100,000. A context of civil conflict, internally displaced people and mining activities suggests a higher regional TB incidence in North Kivu. Medecins Sans Frontieres (MSF) supports the General Reference Hospital of Masisi, North Kivu, covering a population of 520,000, with an elevated rate of pediatric malnutrition. In July 2017, an adapted MSF pediatric TB diagnostic algorithm, including Xpert MTB/RIF on gastric aspirates (GAs), was implemented. The aim of this study was to evaluate whether the introduction of this clinical pediatric TB diagnostic algorithm influenced the number of children started on TB treatment. Methods We performed a retrospective analysis of pediatric TB cases started on treatment in the inpatient therapeutic feeding centre (ITFC) and the pediatric ward. We compared data collected in the second half (July to December) of 2016 (before introduction of the new diagnostic algorithm) and the second half of 2017. For the outcome variables the difference between the two years was calculated by a Pearson Chi-square test. Results In 2017, 94 GAs were performed, compared to none in 2016. Twelve percent (11/94) of samples were Xpert MTB/RIF positive. Sixty-eight children (2.9% of total exits) aged between 3 months and 15 years started TB treatment in 2017, compared to 19 (1.4% of total exits) in 2016 (p 0.002). The largest increase in pediatric TB diagnoses in 2017 occurred in patients with a negative Xpert MTB/RIF result, but clinically highly suggestive of TB according to the newly introduced diagnostic algorithm. Fifty-two (3.1%) children under five years old started treatment in 2017, as compared to 14 (1.3%) in 2016 (p 0.004). The increase was less pronounced and not statistically significant in older patients: sixteen children (2.6%) above 5 years old started TB treatment in 2017 as compared to five (1.3%) in 2016 (p 0.17). Conclusion After the introduction of an adapted clinical pediatric TB diagnostic algorithm, including Xpert MTB/RIF on gastric aspirates, we observed a significant increase in the number of children - especially under 5 years old - started on TB treatment, mostly on clinical grounds. Increased 'clinician awareness' of pediatric TB likely played an important role

malaria infection among schoolchildren in highland Rwanda

Background Plasmodium infection and malaria in school children are increasingly recognized as a relevant public health problem, but data on actual prevalence and health consequences are insufficient. The present study from highland southern Rwanda aimed at estimating infection prevalence among children attending school, at identifying associated factors and at assessing the clinical consequences of these infections. Methods In a survey including 12 schools in the Huye district of Rwanda, 1089 children aged 6–10 years were clinically and anthropometrically examined, malaria parasites were diagnosed by microscopy and PCR, haemoglobin concentrations were measured, and socio- economic and behavioural parameters as well as medical histories were obtained. Results Upon examination, the vast majority of children was asymptomatic (fever 2.7%). Plasmodium infection was detected in 22.4% (Plasmodium falciparum, 18.8%); 41% of these were submicroscopic. Independent predictors of infection included low altitude, higher age, preceding antimalarial treatment, and absence of electricity or a bicycle in the household. Plasmodium infection was associated with anaemia (mean haemoglobin difference of −1.2 g/dL; 95% CI, −0.8 to −1.5 g/dL), fever, underweight, clinically assessed malnutrition and histories of fever, tiredness, weakness, poor appetite, abdominal pain, and vomiting. With the exception of underweight, these conditions were also increased at submicroscopic infection. Conclusion Malaria infection is frequent among children attending school in southern highland Rwanda. Although seemingly asymptomatic in the vast majority of cases, infection is associated with a number of non-specific symptoms in the children´s histories, in addition to the impact on anaemia. This argues for improved malaria surveillance and control activities among school children

The Role of Pharmacovigilance and Drug Utilisation studies in the Track of Antimicrobial Resistance By

La resistència als antimicrobians (RAM) s'ha convertit en una preocupació real per a la salut pública, tot un repte per a les opcions de prevenció i tractament existents que requereix solucions innovadores multidisciplinàries. Els sistemes de salut dels països desenvolupats poden confiar en els serveis de laboratoris ben equipats que poden dur a terme cultius microbians i proves de susceptibilitat al fàrmacs. Tanmateix, molts països d'ingressos baixos i mitjans (LMIC) amb recursos limitats per a posar en marxa laboratoris, requereixen inversions a llarg termini en el seu sistema sanitari que permetin portar a terme activitats de control de la RAM. Aquesta tesi té com a objectiu descriure la contribució potencial de la xarxa mundial de centres i bases de dades de farmacovigilància en el procés de mapatge i estimació de la RAM tot explorant l'ús potencial de mesures indirectes en entorns amb pocs o cap laboratori en el marc de l'anomenada antimicrobial stewardship (AMS). En un ampli estudi basat en dades de seguretat obtingudes de la base de dades de farmacovigilància mundial (VigiBase), d'una llarga llista de més de 23.000 codis MedDRA per a termes preferents, hem identificat una llista curta de 17 codis rellevants per a la gestió antimicrobiana. Els 17 codis haurien de ser la base d'una discussió innovadora sobre com integrar la recopilació de dades basada en MedDRA en les estratègies de vigilància de la resistència als antimicrobians. En un estudi pilot realitzat en un país amb un sistema de farmacovigilància madur (els Països Baixos), vam analitzar els informes de reaccions adverses a medicaments (ADR) de la base de dades de farmacovigilància. En aquesta tesi es presenten els resultats que confirmen l'ús dels codis MedDRA rellevants a l'AMR en una base de dades nacional. L'AMS és un programa complex que inclou un conjunt heterogeni de mesures i activitats destinades a reduir l'ús inadequat d'antimicrobians. En aquesta tesi, proposem una nova eina d'AMS que, alhora, dona una altra dimensió a les funcions de farmacovigilància existents. En concret, descrivim un conjunt de codis MedDRA rellevants per a la vigilància de la RAM, ja que contenen un missatge de presumpta resistència, presumpta ineficàcia, ús fora d'indicació i errors de medicació. Els 17 codis inclouen informació de seguretat, però també de problemes relacionats amb l'ús antibiòtics; proposem que s'utilitzi aquesta informació com a part de les activitats d'AMS. La xarxa mundial de farmacovigilància cobreix més de 170 països que utilitzen codis únics del diccionari MedDRA per recopilar i classificar notificacions d'ADR. Les tecnologies de mineria de dades es poden utilitzar per obtenir informació important sobre sospites de resistència als antimicrobians i casos sospitosos d'ús inadequat. Això també podria conduir a una aproximació simbiòtica que contribueixi a l'enfortiment dels sistemes de farmacovigilància i, al mateix temps, abordar el problema de l'escassetat de dades de RAM, especialment en entorns de recursos limitats.La resistencia a los antimicrobianos (AMR) se ha convertido en un verdadero problema de salud pública, desafiando todas las opciones de prevención y tratamiento existentes ; por tanto, requiere soluciones innovadoras multidisciplinarias. Los sistemas de salud de los países desarrollados pueden contar con laboratorios bien establecidos que pueden realizar cultivos microbianos y pruebas de sensibilidad a los antibióticos. Sin embargo, en muchos países de ingresos medianos y bajos (LMIC) con pocos recursos para laboratorios, se requieren inversiones a largo plazo en sistemas de salud que permitan actividades de monitoreo de AMR en laboratorios. Esta tesis tiene como objetivo describir la contribución potencial de la red global de centros de farmacovigilancia y sus bases de datos en el proceso de mapeo y estimación del impacto de la AMR. en entornos con menor cobertura de laboratorios, en el marco de la llamada antimicrobial stewardship (AMS). En un amplio estudio sobre los datos de seguridad obtenidos a partir de la base de datos de farmacovigilancia global (VigiBase), de una larga lista de más de 23.000 códigos MedDRA para términos preferentes, hemos aislado una breve lista de 17 códigos relevantes en relación con el uso de antimicrobianos. Los 17 códigos deberían ser la base de un debate adicional sobre cómo integrar la recopilación de datos basada en MedDRA en las estrategias de AMS. En un estudio piloto llevado a cabo en un país con un sistema de farmacovigilancia maduro, analizamos las notificacions de reacciones adversas a medicamentos (RAM) de la base de datos de los Países Bajos. En esta tesis se presentan los resultados que confirman el uso de los códigos MedDRA relevantes para AMR en una base de datos nacional. La AMS es un programa complejo que incluye un conjunto heterogéneo de medidas y actividades destinadas a reducir el uso inadecuado de antimicrobianos. En esta tesis, proponemos una nueva herramienta para la AMS que, al mismo tiempo, proporciona otra dimensión a las funciones existentes de Farmacovigilancia. Específicamente, describimos un conjunto de códigos MedDRA relevantes para la vigilancia de la AMR, ya que transmiten una idea sobre sospecha de resistencia, sospecha de ineficacia, uso no autorizado y error de medicación. Los 17 códigos también son indicadores de seguridad, y proponemos leer su mensaje a través de la perspectiva de la AMS. La red global de farmacovigilancia incluye más de 170 países que utilizan códigos únicos del diccionario MedDRA para recopilar y recopilar informes de RAM. Las tecnologías de minería de datos se pueden utilizar para obtener información importante ante la sospecha de resistencia a los antimicrobianos así como sospechas de uso inadecuado. Esto podría conducir a un enfoque simbiótico que contribuya al fortalecimiento de los sistemas de farmacovigilancia al tiempo que se aborda el problema de la escasez de datos de AMR, especialmente en entornos con recursos limitados.Antimicrobial resistance (AMR) has become a real public health concern, challenging all existing prevention and treatment options, and requiring multidisciplinary innovative solutions. Health systems in developed countries can rely on the well-established laboratory services that can carry out microbial cultures and drug-susceptibility tests. However, for many low- and middle-income countries (LMICs) with limited laboratory resources, it still requires long-term investments into health have systems that provide laboratory-based AMR monitoring activities. Exploring the potential use of other indirect measures that can provide estimates of the growing AMR burden in settings with weak laboratory capacity, this thesis aims at describing the potential contribution of the global network of Pharmacovigilance centers and databases in the process of mapping and estimating the AMR burden in settings with less laboratory coverage and capacity, within the framework of AMS. In a large study based on safety data retrieved from the global pharmacovigilance database (VigiBase), from a long list of more than 23,000 MedDRA codes for Preferred Terms, we have isolated a short list of 17 codes that are relevant to antimicrobial stewardship. The 17 codes should be the basis of a further discussion on how to integrate MedDRA-based data collection into antimicrobial resistance surveillance strategies. In a pilot study carried out in a country with a mature pharmacovigilance system, we analysed adverse drug reaction (ADR) reports from The Netherlands Pharmacovigilance database. Results confirming use of the AMR-relevant MedDRA codes in a national database are presented in this thesis. Antimicrobial stewardship is complex program which includes a heterogenous set of measures and activities aiming to reduce inappropriate use of antimicrobials. In this thesis, we propose a new antimicrobial stewardship tool which as the same time gives another dimension to existing functions of Pharmacovigilance. Specifically, we describe a set of MedDRA codes relevant to AMR surveillance as they carry a message of suspected resistance, suspected ineffectiveness, off label use and medication error. The 17 codes are messengers with safety information, and we propose to read their message through an antimicrobial stewardship lens. The global Pharmacovigilance network covers more than 170 countries using unique codes from the MedDRA dictionary to collect and collate ADR reports. Data mining technologies can be used to pull out important information on suspicion of antimicrobial resistance and suspected cases of inappropriate use of antimicrobials. This could also lead to a potentially symbiotic approach which contributes to the strengthening of PV systems while addressing the issue of AMR data scarcity, especially in resource-limited settings

The Role of Pharmacovigilance and Drug Utilisation studies in the Track of Antimicrobial Resistance By

La resistència als antimicrobians (RAM) s’ha convertit en una preocupació real per a la salut pública, tot un repte per a les opcions de prevenció i tractament existents que requereix solucions innovadores multidisciplinàries. Els sistemes de salut dels països desenvolupats poden confiar en els serveis de laboratoris ben equipats que poden dur a terme cultius microbians i proves de susceptibilitat al fàrmacs. Tanmateix, molts països d’ingressos baixos i mitjans (LMIC) amb recursos limitats per a posar en marxa laboratoris, requereixen inversions a llarg termini en el seu sistema sanitari que permetin portar a terme activitats de control de la RAM. Aquesta tesi té com a objectiu descriure la contribució potencial de la xarxa mundial de centres i bases de dades de farmacovigilància en el procés de mapatge i estimació de la RAM tot explorant l’ús potencial de mesures indirectes en entorns amb pocs o cap laboratori en el marc de l’anomenada antimicrobial stewardship (AMS). En un ampli estudi basat en dades de seguretat obtingudes de la base de dades de farmacovigilància mundial (VigiBase), d’una llarga llista de més de 23.000 codis MedDRA per a termes preferents, hem identificat una llista curta de 17 codis rellevants per a la gestió antimicrobiana. Els 17 codis haurien de ser la base d’una discussió innovadora sobre com integrar la recopilació de dades basada en MedDRA en les estratègies de vigilància de la resistència als antimicrobians. En un estudi pilot realitzat en un país amb un sistema de farmacovigilància madur (els Països Baixos), vam analitzar els informes de reaccions adverses a medicaments (ADR) de la base de dades de farmacovigilància. En aquesta tesi es presenten els resultats que confirmen l’ús dels codis MedDRA rellevants a l’AMR en una base de dades nacional. L’AMS és un programa complex que inclou un conjunt heterogeni de mesures i activitats destinades a reduir l’ús inadequat d’antimicrobians. En aquesta tesi, proposem una nova eina d’AMS que, alhora, dona una altra dimensió a les funcions de farmacovigilància existents. En concret, descrivim un conjunt de codis MedDRA rellevants per a la vigilància de la RAM, ja que contenen un missatge de presumpta resistència, presumpta ineficàcia, ús fora d’indicació i errors de medicació. Els 17 codis inclouen informació de seguretat, però també de problemes relacionats amb l’ús antibiòtics; proposem que s’utilitzi aquesta informació com a part de les activitats d’AMS. La xarxa mundial de farmacovigilància cobreix més de 170 països que utilitzen codis únics del diccionari MedDRA per recopilar i classificar notificacions d’ADR. Les tecnologies de mineria de dades es poden utilitzar per obtenir informació important sobre sospites de resistència als antimicrobians i casos sospitosos d’ús inadequat. Això també podria conduir a una aproximació simbiòtica que contribueixi a l’enfortiment dels sistemes de farmacovigilància i, al mateix temps, abordar el problema de l’escassetat de dades de RAM, especialment en entorns de recursos limitats.La resistencia a los antimicrobianos (AMR) se ha convertido en un verdadero problema de salud pública, desafiando todas las opciones de prevención y tratamiento existentes ; por tanto, requiere soluciones innovadoras multidisciplinarias. Los sistemas de salud de los países desarrollados pueden contar con laboratorios bien establecidos que pueden realizar cultivos microbianos y pruebas de sensibilidad a los antibióticos. Sin embargo, en muchos países de ingresos medianos y bajos (LMIC) con pocos recursos para laboratorios, se requieren inversiones a largo plazo en sistemas de salud que permitan actividades de monitoreo de AMR en laboratorios. Esta tesis tiene como objetivo describir la contribución potencial de la red global de centros de farmacovigilancia y sus bases de datos en el proceso de mapeo y estimación del impacto de la AMR. en entornos con menor cobertura de laboratorios, en el marco de la llamada antimicrobial stewardship (AMS). En un amplio estudio sobre los datos de seguridad obtenidos a partir de la base de datos de farmacovigilancia global (VigiBase), de una larga lista de más de 23.000 códigos MedDRA para términos preferentes, hemos aislado una breve lista de 17 códigos relevantes en relación con el uso de antimicrobianos. Los 17 códigos deberían ser la base de un debate adicional sobre cómo integrar la recopilación de datos basada en MedDRA en las estrategias de AMS. En un estudio piloto llevado a cabo en un país con un sistema de farmacovigilancia maduro, analizamos las notificacions de reacciones adversas a medicamentos (RAM) de la base de datos de los Países Bajos. En esta tesis se presentan los resultados que confirman el uso de los códigos MedDRA relevantes para AMR en una base de datos nacional. La AMS es un programa complejo que incluye un conjunto heterogéneo de medidas y actividades destinadas a reducir el uso inadecuado de antimicrobianos. En esta tesis, proponemos una nueva herramienta para la AMS que, al mismo tiempo, proporciona otra dimensión a las funciones existentes de Farmacovigilancia. Específicamente, describimos un conjunto de códigos MedDRA relevantes para la vigilancia de la AMR, ya que transmiten una idea sobre sospecha de resistencia, sospecha de ineficacia, uso no autorizado y error de medicación. Los 17 códigos también son indicadores de seguridad, y proponemos leer su mensaje a través de la perspectiva de la AMS. La red global de farmacovigilancia incluye más de 170 países que utilizan códigos únicos del diccionario MedDRA para recopilar y recopilar informes de RAM. Las tecnologías de minería de datos se pueden utilizar para obtener información importante ante la sospecha de resistencia a los antimicrobianos así como sospechas de uso inadecuado. Esto podría conducir a un enfoque simbiótico que contribuya al fortalecimiento de los sistemas de farmacovigilancia al tiempo que se aborda el problema de la escasez de datos de AMR, especialmente en entornos con recursos limitados.Antimicrobial resistance (AMR) has become a real public health concern, challenging all existing prevention and treatment options, and requiring multidisciplinary innovative solutions. Health systems in developed countries can rely on the well-established laboratory services that can carry out microbial cultures and drug-susceptibility tests. However, for many low- and middle-income countries (LMICs) with limited laboratory resources, it still requires long-term investments into health have systems that provide laboratory-based AMR monitoring activities. Exploring the potential use of other indirect measures that can provide estimates of the growing AMR burden in settings with weak laboratory capacity, this thesis aims at describing the potential contribution of the global network of Pharmacovigilance centers and databases in the process of mapping and estimating the AMR burden in settings with less laboratory coverage and capacity, within the framework of AMS. In a large study based on safety data retrieved from the global pharmacovigilance database (VigiBase), from a long list of more than 23,000 MedDRA codes for Preferred Terms, we have isolated a short list of 17 codes that are relevant to antimicrobial stewardship. The 17 codes should be the basis of a further discussion on how to integrate MedDRA-based data collection into antimicrobial resistance surveillance strategies. In a pilot study carried out in a country with a mature pharmacovigilance system, we analysed adverse drug reaction (ADR) reports from The Netherlands Pharmacovigilance database. Results confirming use of the AMR-relevant MedDRA codes in a national database are presented in this thesis. Antimicrobial stewardship is complex program which includes a heterogenous set of measures and activities aiming to reduce inappropriate use of antimicrobials. In this thesis, we propose a new antimicrobial stewardship tool which as the same time gives another dimension to existing functions of Pharmacovigilance. Specifically, we describe a set of MedDRA codes relevant to AMR surveillance as they carry a message of suspected resistance, suspected ineffectiveness, off label use and medication error. The 17 codes are messengers with safety information, and we propose to read their message through an antimicrobial stewardship lens. The global Pharmacovigilance network covers more than 170 countries using unique codes from the MedDRA dictionary to collect and collate ADR reports. Data mining technologies can be used to pull out important information on suspicion of antimicrobial resistance and suspected cases of inappropriate use of antimicrobials. This could also lead to a potentially symbiotic approach which contributes to the strengthening of PV systems while addressing the issue of AMR data scarcity, especially in resource-limited settings.Universitat Autònoma de Barcelona. Programa de Doctorat en Farmacologi