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)† | NA |
| 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.