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Reported Tuberculosis in the United States, 2020					minus icon
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			National DataState & Local DataRisk FactorsDemographicsTB Treatment and Case OutcomesDrug-Resistant TBGenotype ClustersEstimates of Recent Transmission					Related Pages
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Risk FactorsOn This Page
			HighlightsMedical ConditionsCongregate SettingsSubstance UseData TablesHighlightsSome 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 and
Human immunodeficiency virus (HIV) infection.Social and occupational factors include:
Employment or residence in a correctional facility or long-term care facility,
Experiencing homelessness, and
Substance use.Medical ConditionsMedical conditions 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 2020, diabetes mellitus (22.5%) was the most commonly reported medical risk factor for TB (TB Risk Factors, by Origin and Race/Ethnicity: 2020 and TB Risk Factors: Reporting Areas, 2020).
Among persons with TB disease in 2020, diabetes mellitus is more common among non-U.S.–born persons (25.8%) than U.S.-born persons (14.3%) (TB Risk Factors, by Origin and Race/Ethnicity: 2020).
**Human immunodeficiency virus (HIV)**
TB Incidence Rates by Origin of Birth, United States, 2011–2020resize iconView LargerCloseTB Incidence Rates by Origin of Birth, United States, 2011–2020download iconDownload 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 2020 who were alive at diagnosis, HIV status was known for 89.8%. Of those persons with TB disease and known HIV status, 4.8% were also living with HIV.
Among persons with TB disease with known HIV status, HIV coinfection occurred for 8.0% of persons aged 25–44 years and 5.9% of persons aged 45–64 years (TB Among Persons with HIV Coinfection: 2011–2020).Congregate SettingsPeople living in congregate settings, including correctional facilities, detention centers, long-term care facilities, and homeless shelters, are at increased risk of becoming infected with TB due to shared airspaces. 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 2020, 2.6% 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, Ages ≥15 Years: Reporting Areas, 2020).
Percentage of TB Cases Estimated to be Attributed to Extensive Recent Transmission by Race/Ethnicity, United States, 2017–2020resize iconView LargerClosePercentage of TB Cases Estimated to be Attributed to Extensive Recent Transmission by Race/Ethnicity, United States, 2017–2020download iconDownload Image[PNG]
Among the 2.6% of persons 15 years of age or older diagnosed with TB disease who were current residents of correctional facilities*,
10.1% were current residents of federal prisons,
25.1% were current residents of state prisons,
22.9% were current residents of local jails,
39.1% were current residents of other facilities.*1.1% were current residents of juvenile facilities and 1.7% were unknown.
**Residents of long-term care facilities**
Percentage of TB Cases,* by Initial Drug Regimen, United States, 2020 (N=7,174)resize iconView LargerClosePercentage of TB Cases,* by Initial Drug Regimen, United States, 2020 (N=7,174)download iconDownload Image[PNG]
During 2020, 1.7% of persons 15 years of age or older diagnosed with TB disease were current residents of long-term care facilities (TB in Long-Term Care Facilities, Ages ≥15 Years: Reporting Areas, 2020).
**People experiencing homelessness**
Among persons 15 years of age or older with TB disease in 2020, 290 (4.3%) reported experiencing homelessness within the 12 months prior to TB diagnosis compared with 383 (4.6%) in 2019 (TB in Persons Experiencing Homelessness, Ages ≥15 Years: Reporting Areas, 2020).Substance UseSubstance use is also a risk factor for becoming infected with TB disease. In 2020, among persons with TB disease aged ≥15 years, the most commonly reported types of substance use during the year preceding diagnosis were
Excess alcohol use; 9.0%*Source: TB Among Persons with Excess Alcohol Use, Ages ≥15 Years: Reporting Areas, 2020*
Noninjection drug use; 6.9%, and***Source: TB Among Noninjection Drug Users, Ages ≥15 Years: Reporting Areas, 2020*
Injection drug use; 1.1%.*Source: *TB Among Injection Drug Users, Ages ≥15 Years: Reporting Areas, 2020****
Learn more in the Executive Commentary.Data Tables
Open All Close AllTB Risk FactorsCharacteristics of TB Cases in GENType Clusters by Alert Levels: 2018–2020
TB Risk Factors: Reporting Areas, 2020
Characteristics of TB Estimated to be Attributed to Recent Transmission: 2019–2020HIV StatusTB Among Persons with HIV Coinfection: 2011–2020
TB by HIV Status: Reporting Areas, 2020Social and Occupational Risk FactorsTB in Correctional Facilities, Ages ≥15 Years: Reporting Areas, 2020
TB in Persons Experiencing Homelessness, Ages ≥15 Years: Reporting Areas, 2020
TB in Long–Term Care Facilities, Ages ≥15 Years: Reporting Areas, 2020
TB Among Injection Drug Users, Ages ≥15 Years: Reporting Areas, 2020
TB Among Noninjection Drug Users, Ages ≥15 Years: Reporting Areas, 2020
TB Among Persons with Excess Alcohol Use, Ages ≥15 Years: Reporting Areas, 2020
TB by Primary Occupation, Ages ≥15 Years: Reporting Areas, 2020Top of Page
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						Page last reviewed:  October 25, 2021					Content source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention homeTuberculosisBasic TB Factsplus iconHow TB SpreadsLatent TB Infection and TB DiseaseSigns & SymptomsTB Risk FactorsExposure to TBTB PreventionVaccinesTB & HIV CoinfectionTB and DiabetesTB TermsPersonal StoriesTesting & Diagnosisplus iconWho Should be TestedTesting for TB InfectionTesting in BCG-Vaccinated PersonsTB Screening and Testing of Health Care PersonnelTesting During PregnancyDiagnosing latent TB infection and TB diseaseTreatmentplus iconDeciding When to Treat Latent TB InfectionTreatment Regimens for Latent TB Infection (LTBI)Treatment for TB DiseaseAdverse EventsTB Treatment of Persons Living with HIVTB Treatment and PregnancyTB Treatment for ChildrenFrequently Asked QuestionsDrug-Resistant TBResearchplus iconTB Epidemiologic Studies Consortiumplus iconResearch ProjectsPublicationsTB Trials Consortiumplus iconStudy DescriptionsBackgroundBehavioral & Social Science ResearchHealth Care Settingsplus iconTB Infection Control in Health Care SettingsResources for TB Screening and Testing of Health Care Personnelplus iconFrequently Asked QuestionsTB in Specific Populationsplus iconHealth DisparitiesAsian PersonsBlack or African American PersonsHispanic or Latino PersonsChildrenPregnancyCorrectional FacilitiesPeople Experiencing HomelessnessInternational TravelersLaboratory Informationplus iconDrug Susceptibility TestingFalse-Positive Investigation ToolkitInterim Laboratory Biosafety Guidance for XDR  tuberculosis strainsModel Performance Evaluation Program (MPEP)Rapid Molecular Testing to Detect Drug-Resistant TB in the USplus iconExecutive SummaryIntroductionBackground on Tests for Molecular Detection of DRGeneral Considerations and Principles for a Molecular DR Testing ServicePossible Scenarios and Scope of Testing for a Molecular DR Testing ServiceResearch NeedsGeneral Recommendations of the Expert PanelCommunication Plan for the ReportRecommendationsReferencesPanel Members and CDC ParticipantsAppendix 1Appendix 2Appendix 3The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TBplus iconGeneral ConsiderationsGeneral Recommendations of the Expert PanelRecommendations to ACET, CDC, DTBEData & Statisticsplus iconTB Incidence in the United StatesReported TB in the US, 2022 Surveillance Reportplus iconNational DataReporting Area DataRisk FactorsDemographicsTB Treatment and Case OutcomesDrug-Resistant TBMolecular SurveillanceTuberculosis in the United States, 2022 (Slide Set)Archived Surveillance Reports and Slide Sets2021 State and City ReportArchived State and City ReportsProfessional Resources & Toolsplus iconTools for Healthcare ProvidersResources for TB Programsplus iconStrengthening Civil Surgeons’ Capacity to Improve LTBI Surveillance and Outcomes Among Status AdjustersNotice of Funding Opportunity (NOFO)Program EvaluationTB Centers of ExcellenceTB Elimination AllianceTB Genotypingplus iconConventional TB GenotypingWhole Genome SequencingTB GIMSAnalytic ToolsLatent Tuberculosis Infection ResourcesPublications & Productsplus iconPatient and Public MaterialsFact SheetsGuidelinesplus iconControl & EliminationDrug-Resistant TBInfection Control & PreventionLaboratory & GenotypingTB & HIVTB in Specific PopulationsTesting & DiagnosisTreatmentVaccines & ImmunizationsArchived TB GuidelinesGuides & Toolkitsplus iconAggregate ReportsCDC TB Surveillance TrainingCore CurriculumEffective TB Interviewing for Contact InvestigationEthnographic GuidesFalse-Positive Investigation ToolkitForging Partnerships to Eliminate TuberculosisGuide to Application of GenotypingLTBI: A Guide for Primary Health Care ProvidersMantoux Tuberculin Skin Testing ProductsReport of Verified Case of Tuberculosis (RVCT)Self-Study ModulesTB Contact Investigation Interviewing Skills CourseTB eDOT ToolkitUnderstanding the TB Cohort Review ProcessNewslettersplus iconTB Notes, No. 4, 2023TB Notes, No. 3, 2023TB Notes. 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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