| Group | Key Drivers |
|---|
| Children & adolescents (<15) | Immature immunity; recent exposure (household contact); rapid progression to disease |
| Young adults (15–35) | High-burden settings: social mixing, occupational risk, HIV coinfection, delayed care-seeking |
| Elderly (>65) | Immunosenescence; comorbidities (diabetes, CKD); reactivation of latent TB; institutional exposure |
Other High-Risk Populations
- Immunocompromised (HIV, TNF-α inhibitors, transplant, silicosis)
- Prisoners / detainees (overcrowding, poor ventilation)
- Homeless / marginally housed
- Substance use disorders
- Healthcare workers (exposure)
- Migrants from high-incidence countries
Prevention Strategies
- BCG vaccine at birth (high-burden countries) – protects against severe childhood TB.
- Latent TB infection (LTBI) treatment: 3–4 month regimens (rifapentine/isoniazid, rifampin) for contacts, HIV+, immunocompromised.
- Infection control: Ventilation, UVGI, respirators in congregate settings.
- Active case finding & prompt treatment (DOTS strategy).
- Address social determinants: Housing, nutrition, poverty reduction.
TB is curable and preventable; ending TB requires biomedical + social interventions.
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