Who is at risk for TB?
Tuberculosis (TB) can affect anyone, but certain groups are more vulnerable to TB than others. People who are frequently in contact with active TB cases in their home or workplace are more likely to be infected with TB. Those who are immunosuppressed or immunocompromised are more likely to progress from TB infection to active TB disease.
What groups are at higher risk for tuberculosis infection?
Groups at higher risk for tuberculosis infection (TBI) and TB transmission include close contacts of active TB cases, people from areas with a high incidence of TB, children and residents or employees of congregate settings like long-term care and correctional facilities. Healthcare providers also require screening for TB to help prevent transmission to vulnerable patients and colleagues.
Who is at increased risk for developing active TB disease?
People more likely to progress from TB infection to active TB disease include those who were recently infected, people living with HIV, those receiving immunosuppressive therapy (such as TNF-a inhibitors) and children aged <5 years.
What is a TB risk assessment?
A TB risk assessment helps to identify people at risk for tuberculosis who may require testing for TB infection or additional medical evaluation. Risk assessment is often part of a routine medical evaluation, especially for those entering a high-risk employment or living setting such as a healthcare facility, correctional facility, school or university.
TB risk factors
Risk factors for tuberculosis acquisition or infection include certain medical conditions, country of birth, recent close contact with TB and recent travel history. Risk factors identified by the WHO and the US CDC include (1,2):
- Conditions such as HIV/AIDS, cancer or organ transplant
- Dialysis or chronic kidney disease (CKD)
- Immunosuppression, TNF inhibitors, corticosteroids
- Substance use disorder (e.g. drugs or alcohol)
- Travel or extended stay in a high-TB-incidence country
- Exposure to a contact with active TB disease
- Employment or residence in a congregate setting
Certain unexplained symptoms, such as a cough lasting more than 2–3 weeks, fever, night sweats, weight loss or hemoptysis (coughing up blood), also warrant evaluation for TB disease
How is TB spread?
Tuberculosis spreads through the air when a person with active TB in their lungs coughs, speaks, sings or sneezes. People nearby can inhale the bacteria and become infected. TB is not spread by touching surfaces, sharing food or casual contact.
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References:
- US CDC. Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis Infection — United States, 2010. MMWR59 RR-5
- World Health Organization. (2020) WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment. https://apps.who.int/iris/bitstream/handle/10665/331170/9789240001503-eng.pdf
- US CDC. About tuberculosis. https://www.cdc.gov/tb/about/index.html
US CDC. Provisional 2024 tuberculosis data, United States. https://www.cdc.gov/tb-data/2024-provisional/index.html - 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 assaessment, radiography, and other medical and diagnostic evaluations.