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Volume 32, Number 6—June 2026
Research
Characteristics of Plausible Source Cases Responsible for Recent Mycobacterium tuberculosis Transmission, United States, 2018–2022
Table 5
Multivariable model results for most likely plausible source TB cases during 2018–2020 responsible for recent Mycobacterium tuberculosis transmission during 2020–2022, United States
| Characteristics |
Plausible sources, no. (%) |
aOR (95% CI) |
|---|---|---|
| Total no. cases, (%); n = 19,126 | 637 (3.3) | NA |
| Sex | ||
| M | 449 (70.5) | 1.26 (1.05–1.52) |
| F |
188 (29.5) |
Referent |
| Age, y | ||
| 10–14 | 6 (0.9) | 2.00 (0.83–4.82) |
| 15–24 | 92 (14.4) | 3.03 (2.15–4.27) |
| 25–44 | 236 (37.1) | 2.56 (1.90–3.45) |
| 45–64 | 240 (37.7) | 2.38 (1.78–3.19) |
| >65 |
63 (9.9) |
Referent |
| Origin of birth | ||
| United States | 341 (53.5) | 1.95 (1.58–2.41) |
| Outside United States |
296 (46.5) |
Referent |
| Race and ethnicity† | ||
| Hispanic or Latino | 235 (36.9) | 1.72 (1.25–2.35) |
| American Indian/Alaska Native | 22 (3.5) | 2.71 (1.47–4.98) |
| Native Hawaiian/Pacific Islander | 23 (3.6) | 5.72 (3.30–9.93) |
| Black | 216 (33.9) | 1.90 (1.42–2.55) |
| Asian | 72 (11.3) | 0.76 (0.52–1.11) |
| White |
69 (10.8) |
Referent |
| Experiencing homelessness within past 12 mo. | ||
| Y | 88 (13.8) | 1.59 (1.22–2.07) |
| N | 537 (84.3) | Referent |
| Unknown |
12 (1.9) |
1.73 (0.88–3.38) |
| Noninjection drug use within past 12 mo. | ||
| Y | 144 (22.6) | 1.49 (1.19–1.87) |
| N | 468 (73.5) | Referent |
| Unknown |
25 (3.9) |
1.42 (0.87–2.31) |
| Sputum smear | ||
| Positive | 494 (77.5) | 2.33 (1.85–2.93) |
| Negative | 112 (17.6) | Referent |
| Not done |
31 (4.9) |
1.14 (0.74–1.76) |
| Cavitary disease‡ | ||
| Y | 438 (68.8) | 2.07 (1.70–2.52) |
| N | 181 (28.4) | Referent |
| Unknown |
18 (2.8) |
0.54 (0.33–0.89) |
| Type of therapy | ||
| Directly observed therapy alone | 413 (64.8) | 0.62 (0.43–0.90) |
| Self-administered therapy alone | 7 (1.1) | 0.38 (0.17–0.88) |
| Both | 173 (27.2) | 0.55 (0.37–0.81) |
| Unknown |
44 (6.9) |
Referent |
| Social Vulnerability Index score§ | ||
| SES—no health insurance | NA | 1.12 (1.04–1.21) |
*Outcome of plausible source versus not plausible source for all cases of tuberculosis disease with a genotyped isolate. Excludes cases with missing sex, origin of birth, race/ethnicity, unknown sputum smear status, and children 0–4 years of age. Most likely plausible source identified for each secondary case is included (Figure 1). aOR, adjusted odds ratio; NA, not applicable; SES, socioeconomic status; TB, tuberculosis. †Except for Hispanic or Latino, all are non-Hispanic. ‡Evidence of 1 or more lung cavities with chest radiograph, chest computerized tomography scan, 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.