Introduction
Reported tuberculosis (TB) disease incidence increased in the United States in 2023.
In 2023, reported TB disease cases and incidence rate (number of TB cases per 100,000 persons) in the United States increased for the third year in a row. The TB case count in 2023 is the highest reported since 2013, and the incidence rate is the highest since 2016.
Anyone can get TB disease, but some persons are at greater risk than others.
TB disease in the United States disproportionately affects some groups more than others. A person's risk of TB exposure or progression to disease is higher depending on certain characteristics, such as:
- Origin of birth,
- Weakened immune systems (as a result of certain medications or health conditions [such as diabetes or HIV]),
- Living or working conditions,
- Social behaviors, and
- Age.
Consistent with previous years, birth outside of the United States remained a key risk factor for TB disease in 2023. The TB incidence rate was 18 times higher among non-U.S.–born persons compared with U.S.-born persons.
Despite prevention efforts, TB affects some groups of people more than others. In the United States, TB adversely affects groups that have historically experienced greater obstacles to health care.
Comprehensive evaluation and completion of treatment is important to cure TB disease.
All persons with symptoms of TB disease, a positive TB blood test (interferon-gamma release assay [IGRA]) result or a positive tuberculin skin test (TST) result should be medically evaluated for TB disease. A medical evaluation includes a chest radiograph and bacteriologic examination of clinical specimens. In 2023, among persons diagnosed with TB disease:
- More than 90% received a chest radiograph and
- Almost 90% had a sputum sample collected.
The national goal is for 95% of persons diagnosed with TB disease, for whom 12 months or fewer of treatment is indicated, to complete treatment within 12 months. While the percentage of eligible patients who completed therapy within one year has increased since 1993, the nation is still short of the 95% goal. Among patients diagnosed in 2021, the most recent year for which treatment completion data are available, the United States reported the lowest percentage of patients who completed therapy since 2008.
Regaining the momentum to eliminate TB disease in the United States is critical.
The COVID-19 pandemic impacted TB elimination efforts in the United States. The increase in reported cases of TB disease and incidence rates in 2023 underscores the need to regain momentum toward the United States' goal of eliminating TB. Despite the increases, the United States continues to maintain one of the lowest TB incidence rates in the world.
The 2023 edition of Reported Tuberculosis in the United States highlights the services public health programs provided for persons with TB disease even with the challenges associated with the COVID-19 pandemic. To protect people with TB disease and communities from the spread of TB bacteria, public health programs:
- Facilitated prompt TB diagnoses,
- Initiated evidence-based drug treatment regimens, and
- Collaborated with persons with TB through directly observed therapy to ensure treatment completion.
Timely diagnosis and treatment of both TB disease and latent TB infection are critical steps to eliminating TB disease in the United States. To renew progress toward TB elimination, health care providers and public health programs must engage communities in TB elimination efforts. Engaging communities in TB elimination efforts is critical to establish and strengthen partnerships between:
- Health care providers,
- People affected by TB,
- Communities with high risk of TB, and
- Public health programs.
Key findings
Additional information
Reported Tuberculosis in the United States, 2023 is available exclusively online.
For a summary of the data, visit the Executive Commentary. You can access and print available data from the Data Tables.
CDC has a slide set with data visualizations and communication resources about TB disease in the United States.