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TB Management

Risk Groups

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):

  1. People who have spent time with someone who has TB disease
  2. People with HIV infection or another medical problem that weakens the immune system
  3. People who have symptoms of TB disease (fever, night sweats, cough and weight loss)
  4. People from a country where TB disease is common (most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe and Russia)
  5. 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)
  6. 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.

  • 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.
  • 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.
    District nurse at home visit, patient, Healthcare worker
  • 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.
    Latin mother with young girl
  • Long-term care
  • District nurse at home visit, patient, Healthcare worker
  • Latin mother with young girl

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.

We must continue to ensure correct and timely diagnoses and focus on essential TB prevention and control activities (4). Our fight against TB starts with accurate LTBI testing and treatment – to make sure that populations at higher risk of TB infection are protected and LTBI progression to TB disease is avoided.
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Finding ways to integrate TB and COVID-19 care programs

Dr. Alistair Story, from London’s Find&Treat mobile health service discusses the impact of the COVID-19 pandemic on the service and how the lessons learned through years of running the service has helped it to manage the additional burden of COVID-19.

QuantiFERON-TB Gold Plus tubes
Improve TB screening with QFT-Plus
  • Single patient visit
  • Unaffected by BCG vaccination
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  1. Centers for Disease Control and Prevention. Testing for Tuberculosis (TB) factsheet. (accessed October 6, 2021)
  2. Filardo T.D., Feng P., Pratt R.H., Price S.F., Self J.L. (2021) Tuberculosis — United States. MMWR Morb Mortal Wkly Rep 2022;7 1:441, 446.
  3. Centers for Disease Control and Prevention. Trends in Tuberculosis, 2020. (accessed April 7, 2022)
  4. Centers for Disease Control and Prevention. CDC FACT SHEET: TB in the United States, 2021. 

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. QFT-Plus Package Inserts, available in multiple languages, as well as up-to-date licensing information and product-specific disclaimers can be found at
The performance of the USA format of the QFT test has not been extensively evaluated with specimens from individuals who have impaired or altered immune functions, such as those who have HIV infection or AIDS, those who have transplantation managed with immunosuppressive treatment or others who receive immunosuppressive drugs (e.g., corticosteroids, methotrexate, azathioprine, cancer chemotherapy) or in individuals younger than age 17 years.

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