Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released.
Volume 32, Number 6—June 2026
Research
Characteristics of Plausible Source Cases Responsible for Recent Mycobacterium tuberculosis Transmission, United States, 2018–2022
Table 4
Multivariable model results for all plausible source TB cases during 2018–2020 responsible for recent Mycobacterium tuberculosis transmission during 2020–2022, United States*
| Characteristic |
Plausible sources, no. (%) |
aOR (95% CI) |
|---|---|---|
| Total no. (%) cases, n = 19,266 | 886 (4.6)† | |
| Sex | ||
| M | 625 (70.5) | 1.26 (1.07–1.48) |
| F |
261 (29.5) |
Referent |
| Age, y | ||
| 10–14 | 13 (1.5) | 2.26 (1.17–4.10) |
| 15–24 | 120 (13.5) | 3.01 (2.21–4.30) |
| 25–44 | 334 (37.7) | 2.70 (2.08–3.51) |
| 45–64 | 334 (37.7) | 2.51 (1.94–3.25) |
| >65 |
85 (9.6) |
Referent |
| Origin of birth | ||
| United States | 535 (60.4) | 2.41 (1.99–2.91) |
| Outside United States | 351 (39.6) | Referent |
| Unknown |
||
| Race and ethnicity‡ | ||
| Hispanic or Latino | 289 (32.6) | 1.52 (1.15–2.02) |
| American Indian/Alaska Native | 47 (5.3) | 2.12 (1.10–4.06) |
| Native Hawaiian/Pacific Islander | 29 (3.3) | 5.34 (3.11–9.17) |
| Black | 325 (36.7) | 1.82 (1.40–2.36) |
| Asian | 86 (9.7) | 0.63 (0.45–0.90) |
| White | 104 (11.7) | Referent |
| Multiple race |
6 (0.7) |
1.03 (0.41–2.61) |
| Experiencing homelessness within past 12 mo | ||
| Y | 137 (15.5) | 1.89 (1.49–2.39) |
| N | 735 (83.0) | Referent |
| Unknown |
14 (1.6) |
1.22 (0.62–2.39) |
| Noninjection drug use within past 12 mo | ||
| Y | 204 (23.0) | 1.38 (1.12–1.69) |
| N | 646 (72.9) | Referent |
| Unknown |
36 (4.1) |
1.68 (1.08–2.59) |
| Sputum smear | ||
| Positive | 615 (69.4) | 1.71 (1.42–2.07) |
| Negative | 216 (24.4) | Referent |
| Not done |
55 (6.2) |
0.98 (0.69–1.39) |
| Cavitary disease§ | ||
| Y | 536 (60.5) | 1.69 (1.42–2.00) |
| N | 309 (34.9) | Referent |
| Unknown |
41 (4.6) |
0.63 (0.44–0.90) |
| Type of therapy | ||
| Directly observed therapy alone | 591 (66.7) | 0.72 (0.51–1.02) |
| Self-administered therapy alone | 9 (1.0) | 0.35 (0.16–0.73) |
| Both | 230 (26.0) | 0.62 (0.43–0.90) |
| Unknown |
56 (6.3) |
Referent |
| Social Vulnerability Index score¶ | ||
| SES—housing cost burden | NA | 1.20 (1.06–1.36) |
| SES—no health insurance | NA | 1.13 (1.02–1.25) |
*Outcome of plausible source versus not a plausible source for all cases of tuberculosis with a genotyped isolate. Excludes cases with missing sex, origin of birth, race/ethnicity, unknown sputum smear status, 0–4 years of age, and county of residence. All plausible source cases identified by the recent transmission algorithm for a given secondary case are included. aOR, adjusted odds ratio; SES, socioeconomic status; TB, tuberculosis. †Of 19,266 included case-patients. ‡Except for Hispanic or Latino, all are non-Hispanic. §Evidence of >1 lung cavities with chest radiograph, chest computerized tomography, or both. ¶Social Vulnerability Index includes 16 US Census indicators from the 5-year American Community Survey grouped into 4 themes: SES, household characteristics, racial and ethnic minority status, and housing type and transportation. Ranking values range from 0 to 1, and higher values indicate higher vulnerability and are merged to each case using the patient’s county of residence. ORs based on a 0.2-unit (20%) change for that indicator.