Global Tuberculosis Strategies

Table of Contents

CHAPTER ONE: Executive Summary

• Market Potential
• Epidemiology
• Technology
• Scope and Methodology

CHAPTER TWO: The Basics of TuberculosiS

• Tuberculosis Fundamentals
  • Etiology and Pathogenesis
  • Etiology
  • Pathogenesis
  • Primary Infection
  • Secondary/Disseminated Tuberculosis
• Tuberculosis Epidemiology
  • General Epidemiology
  • Molecular Epidemiology

CHAPTER THREE: Tuberculosis Screening and DiagnosiS

• Overview
• Skin Testing
• Laboratory Testing
  • Adenosine Deaminas
  • Nucleic Acid Amplification Tests (NAAT)/Molecular Diagnostics
  • Interferon-
  • Microbiological Studies
  • Culture - vs - Non-Culture Testing
  • Culture-Based Systems
  • Non-Culture Methods
  • Nucleic Acid Amplification (NAA)
  • Diagnostic development must be based on assessment of medical needs.
  • Specifications must be defined.
  • The tests should be designed to be used where the patients are.
  • There is insufficient knowledge about local conditions:
  • High-tech strategies should not be force-fit to low-tech settings:
  • Simplification is needed in the interim:
  • Fundamental research questions must be addressed.
  • Public leadership is required in priority setting:
  • Access and pricing issues must be clarified.

CHAPTER FOUR: Tuberculosis Therapeutics

• Tuberculosis Drugs: First Line
  • Isoniazid (INH)
  • Rifampin (RIF)
  • Ethambutol (EMB)
  • Pyrazinamide (PZA)
• Tuberculosis Drugs: Second Line
  • Aminoglycosides
  • Fluoroquinolones
  • Polypeptides
  • Thioamides
  • Cycloserine
  • p-Aminosalicylic Acid
  • Other Drugs
• Management of Relapse, Treatment Failure, and Drug Resistance
  • Treatment of Tuberculosis in HIV/AIDS Patients
  • Multi-Drug Resistance in Tuberculosis
  • Therapeutic Progress

CHAPTER FIVE: Strategic Assessment of Tuberculosis

• Market Potential
  • Global Tuberculosis Strategies
  • United States Agency for International Development (USAID)
  • The Stop TB Partnership
  • Global Drug Facility (GDF)

APPENDIX: Glossary

table of exhibits

CHAPTER ONE: Executive Summary

• Table 1-1: Estimated Theoretical Total Global Market Potentials for Tuberculosis Testing & Therapeutics Products by Region, 2005 (Millions)
• Figure 1-1: Theoretical Distribution of Global Tuberculosis Therapeutics and Testing Products Markets : 2005
• Figure 1-2: Theoretical Distribution of the Total Global Tuberculosis Testing Products Markets: 2005
• Figure 1-3: Theoretical Distribution of the Total Global Tuberculosis Therapeutics Markets: 2005
• Table 1-2: Global Tuberculosis Incidence by Region: 2005
• Table 1-3: Global Tuberculosis Prevalence by Region: 2005
• Table 1-4: Global Tuberculosis Mortality by Region : 2005

CHAPTER TWO: The Basics of Tuberculosis

• Table 2-1: Global Tuberculosis Incidence by Region: 2005
• Table 2-2: Tuberculosis Incidence in High-Burden Countries: 2005
• Figure 2-1: Global Tuberculosis Incidence Rates by Region: 2005 (Cases per 100,000 Population per Year)
• Figure 2-2: Global Tuberculosis Incidence Distribution by Region: 2005
• Figure 2-3: Global Tuberculosis Incidence Distribution versus Population Distribution by Region: 2005
• Figure 2-4: Global Tuberculosis Incidence Rates by Region: 1990 - vs - 2005 (Cases per 100,000 Population per Year)
• Table 2-3: Global Tuberculosis Prevalence by Region: 2005
• Table 2-4: Tuberculosis Prevalence in High-Burden Countries: 2005
• Table 2-4: Tuberculosis Prevalence in High-Burden Countries: 2005
• Figure 2-5: Global Tuberculosis Prevalence Rates by Region: 2005 (Cases per 100,000 Population per Year)
• Figure 2-6: Global Tuberculosis Prevalence Distribution by Region: 2005
• Figure 2-7: Global Tuberculosis Prevalence Distribution versus Population Distribution by Region: 2005
• Figure 2-8: Global Tuberculosis Prevalence Rates by Region: 1990 - vs - 2005 (Cases per 100,000 Population per Year)
• Table 2-5: Global Tuberculosis Mortality by Region(Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, Western Pacific), 2005
• Table 2-6: Tuberculosis Mortality in High-Burden Countries: 2005
• Figure 2-9: Global Tuberculosis Mortality Rates by Region: 2005
• Figure 2-10: Global Tuberculosis Mortality Distribution by Region: 2005
• Figure 2-11: Global Tuberculosis Mortality Distribution versus Population Distribution by Region: 2005
• Figure 2-12: Global Tuberculosis Mortality Rates by Region: 1990 - vs - 2005
• Figure 2-13: Comparison of Tuberculosis Incidence, Prevalence and Mortality by Region: 2005
• Figure 2-14: Comparison of Tuberculosis Incidence, Prevalence and Mortality Rates by Region, 2005
• Table 2-7: Global HIV-Associated Tuberculosis Incidence by Region: 2005
• Figure 2-15: Global HIV-Associated Tuberculosis Incidence Rates by Region: 2005
• Figure 2-16: Global HIV-Associated Tuberculosis Incidence Distribution by Region: 2005
• Table 2-8: Global HIV-Associated Tuberculosis Prevalence by Region (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, Western Pacific): 2005
• Figure 2-17: Global HIV-Associated Tuberculosis Prevalence Rates by Region, 2005 (Cases per 100,000 Population per Year
• Figure 2-18: Global HIV-Associated Tuberculosis Prevalence Distribution by Region, 2005
• Table 2-9: Global HIV-Associated Tuberculosis Mortality by Region (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, Western Pacific), 200
• Figure 2-19: Global HIV-Associated Tuberculosis Mortality Rates by Region: 2005 (Deaths per 100,000 Population per Year
• Figure 2-20: Global HIV-Associated Tuberculosis Mortality Distribution by Region: 200

CHAPTER THREE: Tuberculosis Screening and Diagnosi

• Table 3-1: USDHHS Classification System for Tuberculosi
• Table 3-2: CDC Classification System for Tuberculosis in Refugees and Immigrants
• Table 3-3: Molecular Diagnostic Assay Products for the Diagnosis of Tuberculosis and Tuberculosis-Like Condition
• Table 3-4: Rapid Culture-Based Diagnostic and DST Product
• Table 3-5: Phage-Based Tests
• Tale 3-6: Manufacturers and Tuberculosis Tests Reviewed by WHO
• Table 3-7: Antigen-Based Tuberculosis Diagnosis Tests
• Table 3-8: Nucleic Aid Amplification Tests for Tuberculosis Diagnosis
• Table 3-9: Other Non-Culture Tests for Tuberculosis Diagnosis

CHAPTER FOUR: Tuberculosis Therapeutics

• Table 4-1: Rating System for the Strength of Treatment Recommendations Based on Quality of Evidence
• Table 4-2: General Regimen for the Dosing of First-Line Antituberculosis Drugs
• Table 4-3: Drug Regimens for Culture-Positive Pulmonary Tuberculosis Caused by Drug-Susceptible Organisms
• Table 4-4: General Regimen for the Dosing of Second-Line Antituberculosis Drugs
• Table 4-5: Number and Percentage of MDR-TB and XDR-TB Cases by Geographic Region: 2000 - 2004
• Table 4-6: New Therapeutics for Tuberculosis in Development

CHAPTER FIVE: Strategic Assessment of Tuberculosis

• Figure 5-1: Theoretical Distribution of Global Tuberculosis Therapeutics and Testing Products Markets: 2005
• Figure 5-2: Theoretical Distribution of the Total Global Tuberculosis Testing Products Markets: 2005
• Figure 5-3: Theoretical Distribution of Global Tuberculosis Testing Products Markets for Screening: 2005
• Figure 5-4: Theoretical Distribution of Global Tuberculosis Testing Products Markets for Diagnosis/Susceptibility Testing: 2005
• Table 5-2: Estimated Theoretical Total Global Market Potentials for Tuberculosis Testing Products: 2005 (Millions)
• Figure 5-5: Theoretical Distribution of the Total Global Tuberculosis Therapeutics Markets: 2005
• Figure 5-6: Theoretical Distribution of Global Non-MDR Tuberculosis Therapeutics Markets: 2005
• Figure 5-7: Theoretical Distribution of Global MDR/XDR Tuberculosis Therapeutics: 2005
• Table 5-3: Estimated Theoretical Total Global Market Potentials for Tuberculosis Therapeutics: 2005
• Figure 5-8: Realistic Distribution of Global Tuberculosis Therapeutics and Testing Products Markets: 2005
• Table 5-4: Estimated Realistic Global Market Potentials for Tuberculosis Therapeutics and Testing Products: 2005
• Figure 5-9: Realistic Distribution of the Total Global Tuberculosis Testing Products Markets: 2005
• Figure 5-10: Realistic Distribution of Global Tuberculosis Testing Products Markets for Screening, 2005
• Figure 5-11: Realistic Distribution of Global Tuberculosis Testing Products Markets for Diagnosis/Susceptibility Testing: 2005
• Table 5-5: Estimated Realistic Total Global Market Potentials for Tuberculosis Testing Products: 2005
• Figure 5-12: Realistic Distribution of the Total Global Tuberculosis Therapeutics Markets, 2005
• Figure 5-13: Realistic Distribution of Global Non-MDR Tuberculosis Therapeutics Markets: 2005
• Figure 5-14: Realistic Distribution of Global MDR/XDR Tuberculosis Therapeutics: 2005
• Table 5-6: Estimated Realistic Total Global Market Potentials for Tuberculosis Therapeutics: 2005