Tuberculosis

Tuberculosis (TB) is one of the infectious diseases of concern. TB case rates tend to be higher on the border and among people who are forced to move. Between 2019 and 2021, 71% of TB cases occurred among non-US-born persons. TB is also a challenging disease to treat because of the long treatment period, which is complicated when an individual has to move during treatment.

People with certain comorbidities are at greater risk of TB. Those with diabetes and/or HIV are particularly at risk. People being treated for autoimmune disorders, and people taking immunosuppressants like those with organ transplants or those in the midst of chemotherapy are also at greater risk of TB infection.

A majority of TB cases are among the unemployed or precariously employed, but some workers are at higher risk. About 3.7% of US TB cases between 2010 and 2016 were among health care personnel. Farmworkers, particularly those who move with the seasons, are also at increased risk. In addition to occupational risks – many farmworkers are provided substandard poorly ventilated bunkhouses and other on-farm housing that may promote the spread of TB – farmworkers also have limited access to TB testing and care, because of a lack of health insurance, transportation, linguistic barriers, inflexible work situations, and more. 

Those who must move during treatment struggle to complete treatment, as the regimen is lengthy and few people can independently navigate multiple health systems at each location to prevent treatment disruption. MCN's Health Network has a long history of assisting health centers, health departments, and other public health institutions in coordinating TB care for migrants, including virtual Directly Observed Therapy (DOT). Since 1995, Health Network has connected more than 15,000 people with TB and other health needs to the care they need, all across the US and 149 nations.

However, efforts to control and end TB in the United States cannot focus exclusively on cases within our borders or on surveillance alone. In this age of movement, founded on the global market and international travel, no country stands alone in terms of infectious disease. TB, like other communicable diseases, knows no borders. In order to eliminate TB in the United States, the US must take part in international control efforts.

For more information and resources to diagnose, manage, and treat tuberculosis, view our Toolbox.