Tuberculosis before and during COVID-19 Pandemic, United States, 2010–2023

TL;DR

This paper examines how TB cases in the US changed during and after the COVID-19 pandemic compared to previous trends.

Contribution

The study uses statistical models to compare observed TB cases with expected trends during the pandemic.

Findings

TB cases in 2020 were lower than predicted based on pre-pandemic trends.

Migration changes and pandemic-related factors likely caused the drop in TB cases in 2020.

TB cases increased during 2021–2023 after the initial decline in 2020.

Abstract

After a steady decline in tuberculosis (TB) during 2010–2019, the United States reported a sharp drop in 2020 and increases during 2021–2023. We assessed whether TB cases during 2020–2023 differed from what was expected in the absence of the COVID-19 pandemic. Using data from the Centers for Disease Control and Prevention National TB Surveillance System and Electronic Disease Notification system, we constructed Poisson regression models to predict frequencies of TB cases, persons receiving TB diagnosis within 1 year of arrival, and persons for whom postarrival TB follow-up was recommended on the basis of 2010–2019 trends. We observed lower than predicted TB cases (7,170 observed, 8,822 predicted), persons receiving diagnosis within 1 year of arrival (208 observed, 259 predicted), and persons with class B TB (4,827 observed, 7,169 predicted) in 2020. Migration changes and COVID-19–related factors likely contributed to the decrease in TB in 2020 and increases during 2021–2023.

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