Who is at risk for TB?
It is estimated that up to 10% of people infected with M. tuberculosis will develop active tuberculosis (TB) in their lifetime. About one-quarter of the world’s population has a TB infection. The vast majority have no signs or symptoms of TB disease and are not infectious, although they are at risk of developing active TB disease and becoming infectious.
The Centers for Disease Control and Prevention (CDC) and the United States Preventive Services Task Force (USPSTF) recommend testing populations that are at increased risk for TB infection, including (1):
- People who have spent time with someone who has TB disease
- People with HIV infection or another medical problem that weakens the immune system
- People who have symptoms of TB disease (fever, night sweats, cough and weight loss)
- People from a country where TB disease is common (most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe and Russia)
- People who live or work somewhere in the United States where TB disease is more common (homeless shelters, prison or jails or some nursing homes)
- People who use illegal drugs
TB risk groups should be tested for TB bacteria because they are more likely to get TB disease. The purpose of TB screening is to find cases at an early asymptomatic phase that is easily curable and find latent TB infection (LTBI) among individuals who may benefit from preventive treatment.
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Biologics
Treatment with biologic agents, in particular tumor necrosis factor-alpha (TNF-α) inhibitors, has revolutionized the treatment of inflammatory diseases, such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. However, patients receiving anti-TNF-α therapy are at increased risk of TB infection.
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Immuncompromised
People who are immuncompromised, such as people living with HIV, are at increased risk for TB. Reliable surveillance is critical to protecting their health. Timely diagnosis and early treatment can prevent progression from infection to active TB disease.
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Long-term care
About 14 million adults in the United States need long-term care, and over half (56%) are older adults aged 65 and over. These adults living in long-term care facilities have higher rates of TB disease than those living in the community. Screening for latent TB infection in these facilities is critical to prevent the spread of TB.
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Diabetes
Diabetes is increasingly being recognized as an independent risk factor for TB. Someone with untreated latent TB infection and diabetes is more likely to develop TB disease than someone without diabetes. See how the development of TB in diabetes patients can be prevented by actively testing and treating LTBI.
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Pediatrics
Once infected with the TB bacteria, children with vulnerable immune systems are most at risk of progressing to active TB disease. TB is preventable, yet over 1.1 million children become ill with it every year. Find out how we can protect children from TB.
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Healthcare Personnel
Healthcare personnel are at increased risk of tuberculosis infection compared to the general population. How can we protect them and patients in healthcare settings from TB? Learn about TB screening and testing guidelines recommended in healthcare settings for TB control.
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Student Health
Campuses are highly crowded places with the potential for close contact. Therefore, the risks of TB are amplified. How can you make sure your students and faculty are safe from TB? Check out the preferred TB test for college and updated student health TB screening guidance.
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Immigrants
Immigrants often struggle to access proper healthcare, which puts them at a higher risk of getting infected or developing TB. It's time to change that. Let's come together, bridge the gaps and ensure their well-being. See how we can protect immigrants from TB and create a healthier, more inclusive society.
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Biologics
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Immuncompromised
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Long-term care
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Diabetes
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Pediatrics
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Healthcare Personnel
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Student Health
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Immigrants
The CDC is calling out a testing gap. Can we defuse the TB timebomb?
According to a new study published in the CDC’s Morbidity and Mortality Weekly Report, reported TB incidence (cases per 100,000 persons) increased 9.4%, from 2.2 during 2020 to 2.4 during 2021 but was lower than incidence during 2019 (2.7) (2).
Factors contributing to changes in reported TB during 2020–2021 likely include an actual reduction in TB incidence, delayed or missed TB diagnoses and disruptions in healthcare access (3).
The authors warn that continuing underdiagnosis of TB in the U.S. may derail efforts to eliminate the disease, highlighting the importance of evaluation and treatment of latent tuberculosis infection (LTBI) to prevent progression to TB disease.
How can we get U.S. testing back on track?
Contact us
References:
- US CDC. Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis Infection — United States, 2010. MMWR59 RR-5
- US CDC. Tuberculosis — United States, 2023. https://www.cdc.gov/mmwr/volumes/73/wr/mm7312a4.htm
- US CDC. Tuberculosis – data and statistics. https://www.cdc.gov/tb/statistics/default.htm
- US Preventive Services Task Force. Screening for latent tuberculosis infection in adults. JAMA. 2016;316:962–969
- Lewinsohn DM, et al. Official ATS/IDSA/CDC clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017;64:111–115.
QFT -Plus is an in vitro diagnostic aid for detection of Mycobacterium tuberculosis infection. QFT-Plus is an indirect test for M. tuberculosis infection (including disease) and is intended for use in conjunction with risk assessment, radiography, and other medical and diagnostic evaluations.