Asian Community

TB case rates are higher for Asians than whites

In 2018, a total of 9,025 TB cases were reported in the United States; however, Asians continue to be impacted by TB at a greater rate compared to other racial and ethnic groups.

Several important factors contribute to the higher rates of TB among racial/ethnic groups, including Asians. These factors include being born in a country with a high rate of TB or travel to a country with a high rate of TB.

The Numbers

  • In 2018, TB disease was reported in 3,190 Asians in the United States, accounting for nearly 35% of all people reported with TB nationally.
  • The rate in 2018 for Asians is 31 times higher than in non-Hispanic whites.
  • Read more of the 2018 surveillance data in Reported Tuberculosis in the United States, 2018
The distribution of TB patients by race/ethnicity continued to differ markedly by origin of birth. Among US-born TB patients, the largest racial/ethnic group was non-Hispanic blacks (35.7%), followed by non-Hispanic whites (30.3%), Hispanics (22.1%), and non-Hispanic Asians (5.1%). Approximately half of TB cases reported among non-US–born persons occurred among non-Hispanic Asians (48.1%), but followed by Hispanics (31.9%), non-Hispanic blacks (13.4%), and non-Hispanic whites (4.2%).

Countries with highest TB burden among non-U.S.-born Asians, 2018

  1. Philippines
  2. India
  3. Vietnam
  4. China
  5. Myanmar


Prevention Challenges

TB is a challenging disease to diagnose, treat, and control. Dwindling resources and loss of public health capacity, including access to care and maintaining clinical and public health expertise add to the challenge. It is critical to reach those at highest risk for TB, and to identify and implement innovative strategies to improve diagnosis and treatment.

woman with her baby

Similar to other racial and ethnic groups, Asians face a number of challenges that contribute to higher rates of TB. Challenges include:

  • Treatment duration and completion
    • Treatment for TB disease can be lengthy. Patients are often unable or reluctant to take medication for several months. For people with TB disease, inadequate treatment can lead to treatment failure, relapse, ongoing transmission, and development of drug resistance.
    • For people with latent TB infection, medication for a condition with no symptoms of illness is often not a priority.
  • Socioeconomic factors
    • Poverty, including limited access to quality health care, unemployment, housing, and transportation, are associated with adverse health outcomes. These factors can directly or indirectly increase the risk for TB disease and present barriers to treatment.
    • Language and cultural barriers, including health knowledge, stigma associated with the disease, values, and beliefs may also place certain populations at higher risk. Stigma may deter people from seeking medical care or follow up care.
  • Testing and Diagnosis
    • Many people born outside of the United States have been given a vaccine called BCG. Vaccination with BCG may cause a false positive reaction to a TB skin test. A positive reaction to a TB skin test may be due to the BCG vaccine itself or due to infection with TB bacteria. TB blood tests are not affected by prior BCG vaccination and are not expected to give a false-positive result in people who have received BCG. TB blood tests are the preferred method of TB testing for people who have received the BCG vaccine.
Page last reviewed: January 31, 2020