Table 1– The current smear microscopy market and the potential market for a replacement test for initial diagnosis of tuberculosis (TB) in the public sector of the 22 high-burden countries
 Country Notified TB cases in 2012 n# Microscopy centres n Total microscopy centres % Total sputum smear volume (millions) Total sputum smear volume % Sputum smear market for initial diagnosis¶ Replacement test market+ Smears n (millions) Estimated (range) expenditure(US$millions) Tests n (millions) Potential market value (US$ millions) Non-BRICS Afghanistan§ 29 578 710 1.7 0.022 0.0 0.017 0.03 (0.02–0.05) 0.009 0.04 Zimbabwe 38 720 220 0.5 0.064 0.1 0.051 0.09 (0.07–0.14) 0.025 0.13 Cambodia 40 258 214 0.5 0.550 0.7 0.437 0.77 (0.56–1.18) 0.218 1.09 Uganda 47 211 1165 2.7 0.260 0.3 0.206 0.37 (0.26–0.56) 0.103 0.52 Mozambique 50 827 300 0.7 0.248 0.3 0.197 0.35 (0.25–0.53) 0.098 0.49 Thailand 61 208 1081 2.5 1.61 2.1 1.28 2.27 (1.64–3.45) 0.640 3.20 Tanzania 63 892 830 1.9 0.852 1.1 0.677 1.20 (0.87–1.82) 0.338 1.69 Nigeria 97 853 1341 3.1 1.33 1.7 1.06 1.88 (1.36–2.85) 0.530 2.65 Kenya 99 149 1818 4.2 4.86 6.3 3.86 6.83 (4.95–10.40) 1.93 9.64 Vietnam 103 906 818 1.9 2.46 3.2 1.95 3.46 (2.51–5.27) 0.977 4.89 Democratic Republic of Congo 112 499 1522 3.6 0.972 1.3 0.772 1.37 (0.99–2.08) 0.386 1.93 Ethiopia 147 592 2497 5.8 6.04 7.8 4.80 8.51 (6.16–12.94) 2.40 12.0 Burma 148 149 358 0.8 1.17 1.5 0.930 1.65 (1.19–2.51) 0.465 2.33 Bangladesh 173 619 1070 2.5 4.13 5.3 3.28 5.81 (4.21–8.83) 1.64 8.20 Philippines 235 608 2565 6.0 1.81 2.3 1.44 2.54 (1.84–3.87) 0.718 3.59 Pakistan 273 097 1171 2.7 1.79 2.3 1.42 2.52 (1.82–3.83) 0.711 3.55 Indonesia 331 424 5566 13.0 2.04 2.6 1.62 2.88 (2.08–4.38) 0.812 4.06 BRICS countries Brazil 82 755 2510 5.9 1.14 1.5 0.905 1.60 (1.16–2.44) 0.453 2.26 Russian Federation 149 921 1031 2.4 8.86 11.4 7.04 12.5 (9.04–19.0) 3.52 17.6 South Africa 349 582 240 0.6 4.57 5.9 3.63 6.43 (4.66–9.77) 1.81 9.07 China 900 678 2800 6.5 12.0 15.5 9.53 16.9 (12.2–25.7) 4.77 23.8 India 1 467 585 13 000 30.4 20.8 26.8 16.6 29.3 (21.3–44.6) 8.28 41.4 Total 5 005 111 42 827 100 77.6 100 61.7 109 (79.1–166) 30.8 154
• Countries listed in order of the number of notified TB cases in 2012. BRICS: Brazil, Russian Federation, India, China and South Africa. #: data obtained from [12]. : we assumed for all countries that, on average, 79% of the sputum smears were performed for initial diagnosis (the average proportion reported by 11 countries able to stratify smears for initial diagnosis and those performed for treatment monitoring). The number of initial smears was multiplied by US$1.77 (range US$1.28–2.69); the median unit costs for a smear according to Lu et al. [11]. Smear costs included various components (e.g. material, labour, equipment and overheads) although the exact components included differed across studies or were not always reported. +: we assumed that a replacement test would only need a single test on one sample (as opposed to an average of two samples for sputum smear microscopy) and multiplied these by US\$5, the anticipated costs for a hypothetical replacement test. §: smear volumes were recognised to be under-reported by laboratories.