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Tuberculosis (TB)


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Reported Tuberculosis in the United States, 2021										Related Pages
										Return to Main MenuRisk FactorsOn This Page
			HighlightsMedical ConditionsCongregate SettingsSubstance UseData TablesRisk FactorsHighlightsSome people are at greater risk of TB disease compared with others. CDC analyzes factors that increase a person’s risk of becoming infected with or developing TB disease.
Medical conditions that weaken the immune system include:
Diabetes mellitus
Human immunodeficiency virus (HIV) infectionSocial and occupational factors include:
Employment or residence in a correctional facility or long-term care facility
Experiencing homelessness
Substance useMedical ConditionsMedical conditions or therapies that weaken the immune system can increase a person’s risk of developing TB disease if they are infected.
**Diabetes mellitus**
TB disease is a serious health threat, especially for persons with diabetes.
In 2021, diabetes mellitus (23.9%) was the most commonly reported medical risk factor among persons with TB disease (TB Risk Factors by Origin and Race/Ethnicity: 2021 and TB Risk Factors: Reporting Areas, 2021).
Among persons with TB disease in 2021, diabetes mellitus is more common among non-U.S.–born persons (26.7%) compared with U.S.-born persons (16.8%) (TB Risk Factors by Origin and Race/Ethnicity: 2021).
**Human immunodeficiency virus (HIV)**
TB Incidence Rates by Origin of Birth, United States, 2011–2020View LargerCloseTB Incidence Rates by Origin of Birth, United States, 2011–2020Download Image[PNG]
Coinfection with human immunodeficiency virus (HIV) is a major risk factor for progression of latent TB infection to TB disease.
Among persons with TB disease in 2021 who were alive at diagnosis, HIV status was known for 90.5%. Of those persons with TB disease and known HIV status, 4.2% were also living with HIV.
Among persons with TB disease and known HIV status, HIV coinfection occurred for 6.3% of persons aged 25–44 years and 5.6% of persons aged 45–64 years (TB Among Persons with HIV Coinfection: 2011–2021).Congregate SettingsPeople living in congregate settings, including homeless shelters, correctional facilities, detention centers, and long-term care facilities, are at increased risk of becoming infected with TB bacteria because shared airspaces can facilitate TB exposure and transmission. TB bacteria are spread through the air from one person to another. Many congregate settings have shared airspace, which can increase a person’s exposure to TB bacteria and enable the spread of TB bacteria.
**Residents of correctional facilities**
In 2021, 2.4% of persons 15 years of age or older diagnosed with TB disease were current residents of correctional facilities at the time of diagnosis (TB in Correctional Facilities: Reporting Areas, 2021).
Percentage of TB Cases Estimated to be Attributed to Extensive Recent Transmission by Race/Ethnicity, United States, 2017–2020View LargerClosePercentage of TB Cases Estimated to be Attributed to Extensive Recent Transmission by Race/Ethnicity, United States, 2017–2020Download Image[PNG]
Among those*,
12.3% were current residents of federal prisons
27.9% were current residents of state prisons
31.3% were current residents of local jails
27.4% were current residents of other facilities***0.6% were current residents of juvenile facilities and 0.6% were unknown.
**Other facilities include Immigration and Customs Enforcement (ICE) detention centers, Indian reservation facilities (e.g., tribal jails), military stockades and jails, federal park police facilities, police lockups (temporary holding facilities for persons who have not been formally charged in court), or other correctional facilities that are not included in the other specific choices.
**Residents of long-term care facilities**
Percentage of TB Cases,* by Initial Drug Regimen, United States, 2020 (N=7,174)View LargerClosePercentage of TB Cases,* by Initial Drug Regimen, United States, 2020 (N=7,174)Download Image[PNG]
During 2021, 1.5% of persons 15 years of age or older diagnosed with TB disease were current residents of long-term care facilities (TB Social Risk Factors: Reporting Areas, 2021).
**People experiencing homelessness**
Among persons 15 years of age or older with TB disease in 2021, 341 (4.5%) reported experiencing homelessness within the 12 months prior to TB diagnosis (TB Social Risk Factors: Reporting Areas, 2021) This compares with 290 (4.3%) in 2020 (Reported Tuberculosis in the United States, 2020).Substance UseSubstance use is also a risk factor for TB disease. In 2021, among persons with TB disease who were 15 years of age or older, the most commonly reported type of substance use during the year preceding diagnosis was
Excess alcohol use, 8.2%Noninjecting drug use, 7.0%Injecting drug use, 1.1%*Source:**TB Social Risk Factors: Reporting Areas, 2021*
Learn more in the Executive Commentary.Data Tables
Open All Close AllTB Risk FactorsTB Risk Factors: Reporting Areas, 2021
Characteristics of TB Cases in GENType Clusters by Alert Levels: 2019–2021
Characteristics of TB Cases Estimated to be Attributed to Recent Transmission: 2020–2021HIV StatusTB Among Persons with HIV Coinfection: 2011–2021
TB by HIV Status: Reporting Areas, 2021Social and Occupational Risk FactorsTB in Correctional Facilities: 1993 –2021
TB in Correctional Facilities: Reporting Areas, 2021
TB Social Risk Factors: Reporting Areas, 2021
TB by Primary Occupation: Reporting Areas, 2021Top of Page
							
					
							Last Reviewed:  November 29, 2022						Source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
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No. 2, 2023TB Notes. No. 1, 2023TB Notes, No. 4, 2022TB Notes, No. 3, 2022TB Notes, No. 2, 2022TB Notes, No. 1, 2022TB Notes, No. 4, 2021TB Notes, No. 3, 2021TB Notes, No. 2, 2021TB Notes, No. 1, 2021Pamphlets, Brochures, Bookletsplus iconQuestions and AnswersPatient Education SeriesTuberculosis - Get the FactsTuberculosis - The Connection between TB and HIV12-Dose Regimen for Latent TB Infection-Patient Education BrochurePostersplus iconMantoux Tuberculin Skin Test Wall ChartWorld TB DayThink TBStop TBTake on TBReports & Articlesplus iconDTBE Authored Journal ArticlesTuberculosis Laboratory Aggregate ReportsSlide Setsplus iconIntroduction to TuberculosisEpidemiology of Tuberculosis Among Non-U.S.​–Born Persons in the United States, 1993–2016Self-Study Modules on Tuberculosis, 1-5 Slide SetsThe Tuberculosis (TB) in Correctional Settingsplus iconFacilitator GuideIntroduction to TB GenotypingEpidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2017Prevention and Control of Tuberculosis in Correctional and Detention FacilitiesGuidelines for Preventing the Transmission of M. TB in Health care SettingsInvestigation of Contacts of Persons with Infectious TBEpidemiology of Pediatric Tuberculosis in the United StatesTargeted Tuberculosis Testing and Treatment of Latent Tuberculosis InfectionElectronic Tools & ResourcesWeb-Based Courses & Webinarsplus iconTB 101 for Health Care WorkersContent SyndicationInfographicsplus iconSocial Media GraphicsCustomizable Take on TB Infographic with InstructionsEventsWorld TB Dayplus iconU.S. TB ChampionsHistoryFeaturesplus iconTB Risk FactorsTreating Latent TB Infection with Short-Course RegimensWorld Tuberculosis (TB) Day 2021World Tuberculosis (TB) Day 2020Linksplus iconState TB Control OfficesAbout Usplus iconMission Statement and Activitiesplus iconDTBE Strategic PlanNational TB Program ObjectivesOrganization ChartAdvisory Groupsplus iconFederal TB Task Force To receive email updates about this page, enter your email address: Email Address			What's this?				Submit


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