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
CountryNotified TB cases in 2012 n#Microscopy centres nTotal microscopy centres %Total sputum smear volume (millions)Total sputum smear volume %Sputum smear market for initial diagnosisReplacement test market+
Smears n (millions)Estimated (range) expenditure(US$ millions)Tests n (millions)Potential market value (US$ millions)
 Afghanistan§29 5787101.70.0220.00.0170.03 (0.02–0.05)0.0090.04
 Zimbabwe38 7202200.50.0640.10.0510.09 (0.07–0.14)0.0250.13
 Cambodia40 2582140.50.5500.70.4370.77 (0.56–1.18)0.2181.09
 Uganda47 21111652.70.2600.30.2060.37 (0.26–0.56)0.1030.52
 Mozambique50 8273000.70.2480.30.1970.35 (0.25–0.53)0.0980.49
 Thailand61 20810812.51.612.11.282.27 (1.64–3.45)0.6403.20
 Tanzania63 8928301.90.8521.10.6771.20 (0.87–1.82)0.3381.69
 Nigeria97 85313413.11.331.71.061.88 (1.36–2.85)0.5302.65
 Kenya99 14918184.24.866.33.866.83 (4.95–10.40)1.939.64
 Vietnam103 9068181.92.463.21.953.46 (2.51–5.27)0.9774.89
 Democratic Republic of Congo112 49915223.60.9721.30.7721.37 (0.99–2.08)0.3861.93
 Ethiopia147 59224975. (6.16–12.94)2.4012.0
 Burma148 1493580. (1.19–2.51)0.4652.33
 Bangladesh173 61910702. (4.21–8.83)1.648.20
 Philippines235 60825656.01.812.31.442.54 (1.84–3.87)0.7183.59
 Pakistan273 09711712.71.792.31.422.52 (1.82–3.83)0.7113.55
 Indonesia331 424556613. (2.08–4.38)0.8124.06
BRICS countries
 Brazil82 75525105. (1.16–2.44)0.4532.26
 Russian Federation149 92110312.48.8611.47.0412.5 (9.04–19.0)3.5217.6
 South Africa349 5822400.64.575.93.636.43 (4.66–9.77)1.819.07
 China900 67828006.512.015.59.5316.9 (12.2–25.7)4.7723.8
 India1 467 58513 00030.420.826.816.629.3 (21.3–44.6)8.2841.4
Total5 005 11142 82710077.610061.7109 (79.1166)30.8154
  • 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.