L’avvincente scontro tra Preston Lions e FV Academy promette di essere una partita carica di emozioni e suspense, come suggeriscono le quote offerte dai bookmaker. Analizzando le prestazioni sia delle squadre di casa sia delle avversarie, possiamo aspettarci un match equilibrato, ma con una leggera inclinazione a favore dei Lions per quanto riguarda il risultato finale. La difesa sembra essere un punto forte per entrambe le squadre, in quanto i bookmaker offrono quote elevate per entrambe le squadre a segnare poco durante la partita. Allo stesso tempo, la quota per il mercato ‘Over 1.5 Goals’ suggerisce che si potrebbe assistere a un match con un numero giusto di reti.
Predizioni per la Partita: Preston Lions (w) vs FV Academy (w)
1. Doppia possibilità di non marcatura:
- Entrambe le squadre non a segno nella 2ª metà: 97.50
Questo suggerisce una stabilità difensiva notevole, specialmente nella seconda metà della partita. - Entrambe le squadre non a segno nel 1º tempo: 98.20
Un altro segno di partita equilibrata dove le difese potrebbero prevalere.
2. Mercato Goal Totali:
- Sopra 1.5 Goal: 88.00
Quota che indica la probabilità di un minimo di due reti nel corso della partita. - Sopra 2.5 Goal: 80.00
La quota accettabile suggerisce che ci possano essere più di due reti totali in questo scontro. - Sopra 3.5 Goal: 54.20
Questa quota più bassa indica la possibilità di una partita ricca d’azione con almeno quattro reti.
3. Entrambe le squadre a segnare:
- Entrambe le squadre a segnare: 64.90
Dato che questo mercato è più basso rispetto alle altre quote, potremmo aspettarci una partita in cui entrambe le formazioni trovano la via della rete. - Sopra 2.5 BTTS: 61.90
Allargando la finestra a più reti, la probabilità di vedere più di due reti totali da entrambe le squadre è ragionevolmente accettabile.
4. Risultato Finale:
- Vittoria della Squadra di Casa: 55.20
Nonostante le probabilità non siano basse, i Preston Lions hanno una leggera preferenza anche se i margini sono ristretti.
5. Statistiche Medie:
- Gol Totali Medi: 5.01
La media prevede un incontro ricco di reti, confermando l’ipotesi di una partita vivace. - Gol Concessi Medi: 3.16
Entrambe le squadre concedono relativamente molte opportunità agli avversari, suggerendo partite aperte. - Gol Segnati Medi: 1.85
Anche se abbastanza moderata, ciò sottolinea la capacità di concretizzazione di almeno una delle squadre.
Preston Lions (w)
FV Academy (w)
Predictions:
| Market | Prediction | Odd | Result |
|---|---|---|---|
| Both Teams Not To Score In 2nd Half | 98.40% | ||
| Both Teams Not To Score In 1st Half | 98.70% | ||
| Over 1.5 Goals | 86.90% | ||
| Over 2.5 Goals | 80.60% | ||
| Both Teams To Score | 67.30% | ||
| Over 2.5 BTTS | 61.70% | ||
| Over 3.5 Goals | 56.50% | ||
| Home Team To Win | 56.40% | ||
| Avg. Total Goals | 5.11% | ||
| Avg. Conceded Goals | 3.96% | ||
| Avg. Goals Scored | 2.45% |
2: Author: Mwangi Macharia, Alison A. Rasmussen, Negasi Woldie Getachew, et al.
3: Date: 1-1-2021
4: Link: https://doi.org/10.1186/s13104-020-05435-0
5: BMC Research Notes: Research Note
6: ## Abstract
7: ObjectiveHIV prevalence among persons diagnosed with TB in Tanzania is among the highest in the world. Recent estimates show that only half of TB patients were offered HIV testing in the country. To our knowledge, no studies have evaluated uptake of referral by patients following the HIV testing offer in comparison to those who were not referred solely for caregiver reasons-such as advanced age and co-morbidities. We aimed to identify uptake of referrals to HIV counseling and testing in hospitalized TB patients in northern Tanzania.
8: ResultsWe analyzed data from patients aged ≥ 15 years diagnosed with TB between January and December 2018 at Bugando Medical Centre (BMC). We used multivariable regression to identify factors associated with referral uptake. Among all eligible patients, only 61% were referred to HIV counseling and testing following the national guidelines for TB/HIV collaboration in facility-level care. In multivariable regression analysis, older age (≥ 45 years) was associated with lower uptake of referrals to HTS compared to those < 45 years (adjusted odds ratio [AOR] 0.48, 95% confidence interval [CI] 0.26–0.92; p = 0.03). However, sex, having history of previous TB treatment, or being a known HIV-infected patient at registration were not significantly associated with uptake of referrals to HIV testing.
9: ## Introduction
10: Tuberculosis (TB) and human immunodeficiency virus (HIV) are two of the leading causes of death among infectious diseases worldwide [1]. In 2018, an estimated 10 million incident TB cases were globally, of which approximately one-third were co-infected with HIV [2]. Further estimates have shown that more than half of all HIV-related deaths globally are attributable to TB [3]. In sub-Saharan Africa, over five million people have been estimated to be living with both TB and HIV [2].
11: As of 2018, the National Tuberculosis Program (NTP) in Tanzania estimated an HIV prevalence rate of 40% among persons diagnosed with TB [4]. However, despite the increased risk of acquiring TB among people living with HIV (PLWH), only half of patients were reported to have been offered HIV testing [4]. Among PLWH, those who started antiretroviral therapy (ART) were found to have at least a 75% lower risk of developing incident TB [5]. Similarly, persons who receive ART and TB preventive therapy (TPT) have a reduced risk of at least 30% of developing active TB [6]. These findings underscore the need to scale-up HIV testing among all patients diagnosed with TB.
12: Despite the high burden of TB/HIV co-infection in Tanzania and its global implications, we are not aware of studies that have explored actual ethical practices around test-of-cure (TOC) versus caregiver ordered HIV referral in this region. Additionally, there is a paucity of information on uptake of referrals for HIV counseling and testing among hospitalized TB patients exposed to referral services in Tanzania. In this study, we sought to determine the proportion of hospitalized TB patients that were referred to HIV counseling and testing following the test of cure in the multinational Bugando Medical Centre (BMC) using national guidelines [7] and factors influencing the uptake of referrals.
13: ## Main text
14: ### Methods
15: #### Study area, design and participants
16: We conducted this retrospective cohort study at BMC that is situated near Lake Victoria and serves as a regional referral hospital for over seven million people in Mwanza region of northwest Tanzania and neighboring countries including Uganda and DRC. The BMC TB program enrolls all patients diagnosed with TB and provides comprehensive care including free treatment services for TB as well as integrated HIV counseling and testing for TB patients who are at-risk.
17: From medical records, we obtained data from all adult TB patients (≥ 15 years) diagnosed with pulmonary and extrapulmonary TB between January and December 2018. At BMC, all adult TB patients aged ≥ 15 years receive active two-step screening for HIV as recommended by the national guidelines; a provider initiated counseling and testing routinely at registration time (counseling then finger prick rapid test) and again via test-of-cure (TOC) before completion of anti-tuberculous therapy (ATT). For children diagnosed with TB and those who were not fit for HIV testing due to severe disease conditions, we conducted caregiver ordered HIV testing after receiving written consent from parents or legal guardians [7]. For all patients diagnosed with HIV as a result of either TOC or caregiver ordered HIV tests, we offered immediate ART according to national guidelines [8].
18: For the purposes of this analysis, we excluded patients with occupational or latent TB as well as those who were pregnant while on ATT.
19: We calculated the proportion of patients referred to HIV testing service following test-of-cure as well as caregiver referrals. We further determined the proportion of patients who were referred under both standard screening criteria for HIV and as caregiver ordered referrals.
20: #### Statistical analysis
21: We used Stata version 14 [9] to conduct data cleaning, management and analysis including descriptive statistics for all study participants. We compared patient characteristics and proportions between those who accepted referral to those who did not in bivariate analysis using student t-test for continuous variables and Pearson’s Chi-squared test for categorical variables. We then identified factors independently associated with uptake of referral using multivariable logistic regression analysis to calculate odds ratio and their associated unprotected variance.
22: ### Results
23: #### Study participants
24: We reviewed medical records from 602 eligible patients with a median age of 37 years (IQR 26–50 years); majority were married (59%), male (64%) and newly diagnosed (66%). Approximately three-quarters [73%] had pulmonary TB and about one-fifth history of previous TB treatment [20%] (Table 1).
25: **Table 1**Bivariate analysis of categorical variables between patients that accepted referral versus those who did not
26: | Characteristics | Accepted referral | Not accepted referral | P-value† |
27: | — | — | — | — |
28: | Total | N = 367 | N = 235 | |
29: | Age group | | | |
30: | < 45 years | 270 (58%) | 139 (42%) | – |
31: | ≥ 45 years | 97 (21%) | 96 (58%) | < 0.001 |
32: | Sex | | | |
33: | Male | 240 (52%) | 156 (49%) | – |
34: | Female | 126 (27%) | 79 (51%) | 0.09 |
35: | Marital status | | | |
36: | Married | 214 (46%) | 118 (39%) | – |
37: | Not married | 151 (33%) | 117 (61%) | .03 |
38: | Site of TB disease* | | | |
39: | Pulmonary | 261 (56%) | 164 (70%) | – |
40: | Extra-pulmonary | 100 (22%) | 59 (25%) | .15 |
41: | Unknown site | 5 (1%) | 6 (3%) | .39 |
42: | Mixed TB disease* | 1 (< 1%) | – | – |
43: | Previous TB treatment history | – |
44: | No previous treatment | 296 (64%) | 159 (67%) | – |
45: | Previously treated for TB | 70 (15%) | 76 (33%) | < 0.001 |
46: | Type of TB treatment received*†† |
47: | New regimen for newly diagnosed TB | – |
48: | Standard regimen for relapse/refractory/risk TB cases*** | – |
49: | Known HIV status in medical file*††† |
50: | Negative/Unknown status on register | – |
51: | Positive on register at registration time+ |
52: † Pearson’s Chi-squared test
53: *14 records missing; plasma person-time lost = 14 person-years
54: ††19 records missing; plasma person-time lost = 19 person-years
55: †††20 records missing; plasma person-time lost = 20 person-years
56: +10 records missing; plasma person-time lost = 10 person-years
57: #### Referrals and HIV testing among patients
58: During the study period, we referred all eligible adult patients for HIV counseling and testing following national guidelines [7]. From those who were eligible for HIV counseling and testing, the majority [325/602;54%] underwent provider-initiated counseling and testing at registration time followed by test-of-cure before completion of TB treatment. However, less than half of patients [222/365;61%] accepted referrals for HIV counseling and testing following test-of-cure while the rest were referred solely based on caregiver ordered referrals for those who were too sick to be tested for HIV at registration time (n = 90/602;15%) or during TOC at their last visit (n = 11/602;2%). Although we referred all patients for HIV counseling and testing at registration time, we did not have data about the proportion that were tested as it was not mentioned in the medical records.
59: #### Test-of-cure and caregiver ordered referrals
60: Of all referrals made, majority [367/602;61%] was made following TOC at the last follow up visit while approximately four in ten [235/602;39%] was made solely based on caregiver ordered referrals.
61: Fourteen patients [14/602;2%] who presented late prior to completion of their ATT regimen had their follow-up visits with TB services scheduled after December 2018 thereby missing test-of-cure at the last follow-up visit. We excluded these patients from subsequent analysis involving test-of-cure thereafter in our study.
62: #### Predictors of referrals uptake
63: Overall, only six out of ten patients were tested for HIV following referral from the BMC TB clinic at BMC during this study period. In bivariate analysis, variables that were significantly associated with acceptance of referral included age group of ≥ 45 years old (X2 = 20.81, p-value 45 years old patients accepting referral were approximately half that of their younger counterparts.
65: **Table 2**Multivariable regression analysis of predictors associated with referral uptake
66: | Characteristics | Adjusted odds ratio^ | Confidence interval at p-value < 0.05* |
67: | — | — | — |
68: | Age group |
69: | < 45 years old−^¶^^¶^¶^¶^¶^¶^¶#^#^#^# | Reference category0.48+¶^││││││││#^# #^# │ ││ │ │ │ │ │ │││ │ ││ │ ││ │ │ │ │ │ │ ||
70: | ≥ 45 years old+^*│││││││││#^# #^# │ ││ │ │ │ │ │ │││ │ ││ │ │└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└└✚✚✚✚✚✚✚✚✚✚✚✚✚✚✚✚✚✚✚p-value =0.03 |
71: | Previously treated for TB−¶ #▲▲▲▲▲▲▲▲▲▲▲▲+んんんんんパパパPapaパパパパパパパンパンパンパ□□□□□□□□□□□□□□□□□□□□ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □▶▵▵▵▵▵▵▵▵▵▵▵▵AOR =1.67p-value