Pulmonology Book

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Tuberculosis Risk Factors

Aka: Tuberculosis Risk Factors, Tuberculosis Screening Indications, Tb Risk Factors
  1. See Also
    1. Tuberculosis Risk Factors for progression from Latent to Active Disease
    2. Tuberculosis
    3. Tuberculosis Screening in Children
  2. Risk Factors: High Risk for Tuberculosis exposure and Infection (Tuberculosis Screening Indications)
    1. Recent Immigrants (within prior 5 years) from high risk countries (or extended travel to one of these regions)
      1. Africa (esp. Sub-saharan Africa)
      2. Asia (highest risk)
      3. Eastern Europe
      4. Central America
      5. South America
    2. Immunocompromised conditions
      1. Human Immunodeficiency Virus (HIV)
      2. Immune modulators (e.g. Rheumatoid Arthritis)
      3. Diabetes Mellitus
    3. Close contacts of persons known or suspected to have TB
      1. Children exposed to adults in high-risk categories
    4. Substance Abuse
      1. Tobacco Smokers
      2. Alcohol Abuse
      3. Intravenous Drug Abuse (or other Illicit Drug use)
    5. Residents and employees of high-risk congregate setting (e.g. homeless shelter, correctional facility)
    6. Medically underserved, low income populations (e.g. homeless)
    7. Health care workers
      1. Tb screening is recommended on newly hired staff
      2. Repeat testing after initial screening should be based on exposure risk
        1. Most U.S. healthcare workers are at low risk similar to general population and do not require routine interval testing
          1. Sosa (2019) MMWR Morb Mortal Wkly Rep 68(19): 439-43 [PubMed]
        2. Indications for repeat Tb Screening at intervals
          1. Known Tuberculosis exposure
          2. Healthcare workers serving high risk populations
          3. Healthcare workers where community TuberculosisPrevalence is higher
          4. Consider periodic screening questions for health care workers to risk stratify for testing
  3. Resources
    1. Tuberculosis in Health Care Settings (CDC)
      1. https://www.cdc.gov/tb/topic/infectioncontrol/

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