What are all the risk factors for tuberculosis (TB)?

From the Guidelines

Risk factors for tuberculosis include close contact with someone who has active TB, living or traveling in areas with high TB rates, having a weakened immune system, and other specific conditions or exposures that increase susceptibility to the disease. The risk factors for tuberculosis can be broadly categorized into several groups, including:

• Close contact with someone who has active TB
• Living or traveling in areas with high TB rates
• Having a weakened immune system due to conditions such as HIV/AIDS, diabetes, or the use of certain medications like corticosteroids or TNF inhibitors
• Other specific conditions or exposures, such as organ transplants, cancer, malnutrition, living in crowded or poorly ventilated conditions, working in healthcare settings, homelessness, substance abuse, and being in correctional facilities
• Certain populations are at higher risk, including those from countries with high TB prevalence, the elderly, children under 5, and people with silicosis
• Previous TB infection increases risk of reactivation, especially within the first two years after exposure
• Smoking and alcohol abuse also contribute to TB risk by weakening lung defenses and impairing immune function, as noted in studies such as 1 and 1
• TB is caused by Mycobacterium tuberculosis bacteria that spread through airborne droplets when infected individuals cough or sneeze, with risk increasing with prolonged exposure in enclosed spaces Understanding these risk factors helps identify those who may benefit from TB screening and preventive treatment, as emphasized in guidelines such as those from the World Health Organization 1 and other studies 1.

From the FDA Drug Label

Persons with the following medical conditions that have been reported to increase the risk of tuberculosis: silicosis; diabetes mellitus; prolonged therapy with adrenocorticosteroids; immunosuppressive therapy; some hematologic and reticuloendothelial diseases, such as leukemia or Hodgkin’s disease; end-stage renal disease; clinical situations associated with substantial rapid weight loss or chronic under nutrition Persons with human immunodeficiency virus (HIV) infection Close contacts of persons with newly diagnosed infectious tuberculosis Recent converters, as indicated by a tuberculin skin test Persons with abnormal chest radiographs that show fibrotic lesions likely to represent old healed tuberculosis Intravenous drug users known to be HIV-seronegative Foreign-born persons from high-prevalence countries who never received BCG vaccine Medically underserved low-income populations, including high-risk racial or ethnic minority populations, especially blacks, Hispanics, and Native Americans Residents of facilities for long-term care

The risk factors for tuberculosis (TB) include:

• Medical conditions:
  • Silicosis
  • Diabetes mellitus
  • Prolonged therapy with adrenocorticosteroids
  • Immunosuppressive therapy
  • Hematologic and reticuloendothelial diseases (e.g., leukemia, Hodgkin’s disease)
  • End-stage renal disease
  • Clinical situations with substantial rapid weight loss or chronic under nutrition
• Infections:
  • Human immunodeficiency virus (HIV) infection
• Exposure:
  • Close contacts of persons with newly diagnosed infectious tuberculosis
• Tuberculin skin test results:
  • Recent converters
  • Persons with abnormal chest radiographs showing fibrotic lesions likely to represent old healed tuberculosis
• Lifestyle:
  • Intravenous drug users known to be HIV-seronegative
• Demographic:
  • Foreign-born persons from high-prevalence countries who never received BCG vaccine
  • Medically underserved low-income populations, including high-risk racial or ethnic minority populations (e.g., blacks, Hispanics, Native Americans)
  • Residents of facilities for long-term care 2

From the Research

Risk Factors for Tuberculosis

The risk factors for tuberculosis (TB) can be categorized into several groups, including:

• Exogenous factors, such as bacillary load in the sputum and proximity to an infectious TB case 3
• Endogenous factors, such as human immunodeficiency virus (HIV) infection, malnutrition, young age, diabetes, indoor air pollution, alcohol use, and tobacco smoke 3
• Socioeconomic and behavioral factors, such as poverty, homelessness, overcrowding, lack of access to piped water and adequate sanitation, and substance use 4, 5
• Health system issues, such as delay in diagnosis of TB 3

Demographic and Socio-Economic Risk Factors

Demographic and socio-economic risk factors associated with self-reported TB include:

• Male-headed households 4
• Overcrowding 4
• Lack of access to piped water and adequate sanitation 4
• Low body mass index (BMI) 5
• Indoor air pollution 5

Other Risk Factors

Other risk factors for TB include:

• HIV infection 6, 3, 7
• Malnutrition 6, 3
• Diabetes 6, 3
• Alcohol abuse 6
• Smoking 6
• Use of immunosuppressive drugs 3
• Health care workers and indigenous populations are also at an increased risk of TB infection and disease 3