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  • 1.
    Alshareef, Hanouf
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik.
    The Effect of Water, Sewage and Hand Hygiene on Waterborne Diseases in Saudi Arabia2021Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [en]

    Waterborne diseases are illnesses caused by microscopic organisms, like viruses, bacteria and  parasites, that transmitted via the fecal-oral route through ingestion of contaminated water or food or by direct person to person contact. The transmission cycle can be broken through safe water supplies, maintaining standards of sanitation and proper handwashing practices. Two waterborne diseases are considered in this study: hepatitis A and amebic dysentery. The study aimed to understand the important factors for preventing waterborne diseases in order to improve public health. A descriptive cross-sectional study was conducted to assess the effect of different drinking water sources, sewage systems and different active practices of soap use for hand washing on incidence of waterborne diseases in different regions in Saudi Arabia. Data was obtained from Ministry of Health and Household Environment Survey provided by General Authority for Statistics. Statistical analysis performed by using general linear model and type II Analysis of Variance. In comparison of different drinking water sources, this study showed borderline rise in incidence of waterborne diseases with the use of private well water. Whereas different sewage systems had no clear effect on the incidence of waterborne diseases. The study also revealed that not using soap for hand washing would increase the risk for hepatitis A infection. Moreover, the study showed significant decline in waterborne diseases incidence when access to filtered water combined with regular soap use in the same linear model.

    Fulltekst (pdf)
    The Effect of Water, Sewage and Hand Hygiene on Waterborne Diseases in Saudi Arabia Hanouf Alshareef
  • 2.
    Faza, Linah
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik, Miljövetenskap.
    The Effect of Socioeconomic, Patient, and Logistic Determinants on Antiretroviral Pre-Treatment Drug Resistance A Regression Analysis Model2022Independent thesis Advanced level (degree of Master (Two Years)), 10 poäng / 15 hpOppgave
    Abstract [en]

    Introduction Human immunodeficiency virus (HIV) is a double stranded RNA retrovirus. According to the World Health Organization more than 30 million individuals were estimated to have HIV by the end of 2020, about 60% of which are in the African region. Pre-treatment drug resistance (PDR) can be defined as the resistant virus strains transmitted at the time of infection or acquired during previous exposure to ARV. This study asses the effect of drivers in PDR.

    Method: This study was conducted with data extracted from published, publicly available data bases and reports by international organizations. The main sources were United Nation data bases and published reports from World Health Organization.  Inferential statistics were used to assess the PDR to anti-retroviral drugs. A linear regression model was used to investigate the association between PDR and previous exposure to anti-retrovirals and anti-retroviral therapy, pre-exposure prophylaxis, national health expenditure, human development index, and drug stock-out for different classes of anti-retroviral drugs.  

    Results: The result indicated that NNRTI drug resistance was most common, and seven out of 29 countries had PDR to all four drug classes. The human development index was positively associated with INSTI and PI PDR (p<0.05), while NNRTI and NRTI were mainly positively associated with previous exposure to anti-retrovirals.

    Conclusion: This study assessed the impact of socio-economics determinants (human development index and national health expenditure), drug logistic determinants (stock-out), and patients’ determinants (adherence and previous exposure to any kind of anti-retrovirals) on PDR. For expensive drug classes (PI and INSTI) the resistance was positively associated with human development index. Previous exposure to anti-retrovirals was associated with increased resistance in NNRTI and NRTI.

    Fulltekst (pdf)
    fulltext
  • 3.
    Rashed, Ismail Ismail Ibrahim
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik.
    The association between vitamin D deficiency and tuberculosis: Effects of different levels of vitamin D deficiency - A meta-analysis2019Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [en]

    Aim: To conduct a systematic review and meta-analysis of all published studies studying the risk of vitamin D deficiency in tuberculosis patients and in healthy controls. Additionally, subgroup meta-analysis was performed based on the level of vitamin D to test the risk in TB groups and in healthy groups.

    Methods: Pubmed was searched for observational studies in human and English that discussed the association between risk of low serum vitamin D and TB. Meta-analysis was performed on all relevant studies combined and for subgroups of each vitamin D level.

    Results: 22 studies were selected and pooled in the analysis. The results were consistent with previous studies examining the same risk. The overall log risk ratio (log RR) of low vitamin D was significantly higher in TB patients 1.68 times than healthy controls. In 4 subgroup meta- analyses based on vitamin D level below (20 nmol/L, 30 nmol/L, 50 nmol/L, and 75 nmol/L), the risk of having low vitamin D in TB patients was (1.82, 2.89, 1.38, 1.32) respectively. That subgroup analysis showed more clearly the higher RR were below 20 and 30 nmol/L. The smallest RR was at 75 nmol/L level.

    Conclusion: This study verified the association between risk of low vitamin D level and TB development. It also clarified that, the risk increased by decreasing vitamin D level.

    Fulltekst (pdf)
    fulltext
  • 4.
    Zaman, Muhammad Haidar
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik.
    Improvement in Hepatitis “C” viral infection with advanced antiviral therapy,treatment – a meta-analysis2015Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [en]

    Background: Hepatitis is the inflammation of liver and there are many reasons of hepatitis. Among these reasons the viral hepatitis due to hepatitis B virus (HBV) and hepatitis C Virus (HCV) are the common hepatic infections and the major causes of liver cancer and liver cirrhosis in the world especially in Asia and Medal east. HBV and HCV infections are having very high mortality ratio in Europe and every year millions of people become infected and die due to HBV or HCV in Europe and Worldwide. That’s why viral hepatitis needs a serious consideration and perfect treatment.

    Objective: Objective of the study was to analyze the role of ribavirin in HCV treatment and to observe the virological response and relapse against it by using statistical meta-analytical techniques.

    Selection criteria and data collection: For this meta-analysis I used the publication databases PubMed, ScienceDirect and Google Scholar to collect all research articles describing treatment and response of HCV and using the antiviral drugs Ledipasvir and Sofosbuvir (control group) in combination with the active agent Ribavirin.

    Method and Methodology: Meta-analysis was performed using the statistical package R and the package metafore.

    Result and conclusion: The result shows that the use of ribavirin with control group (ledipasvir and sofosbuvir) did not show a significant impact on the sustained virological response (SVR) during and after treatment. But addition of ribavirin in control group effectively reduced the rate of relapse after treatment.

    Fulltekst (pdf)
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