{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:43:38Z","timestamp":1792557818815,"version":"4.5.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100005258","name":"National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention","doi-asserted-by":"publisher","award":["U38PS004649"],"award-info":[{"award-number":["U38PS004649"]}],"id":[{"id":"10.13039\/100005258","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Preventing tuberculosis (TB) disease requires treatment of latent TB infection (LTBI) as well as prevention of person-to-person transmission. We estimated the LTBI prevalence for the entire United States and for each state by medical risk factors, age, and race\/ethnicity, both in the total population and stratified by nativity.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We created a mathematical model using all incident TB disease cases during 2013\u20132017 reported to the National Tuberculosis Surveillance System that were classified using genotype-based methods or imputation as not attributed to recent TB transmission. Using the annual average number of TB cases among US-born and non-US-born persons by medical risk factor, age group, and race\/ethnicity, we applied population-specific reactivation rates (and corresponding 95% confidence intervals [CI]) to back-calculate the estimated prevalence of untreated LTBI in each population for the United States and for each of the 50 states and the District of Columbia in 2015.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We estimated that 2.7% (CI: 2.6%\u20132.8%) of the U.S. population, or 8.6 (CI: 8.3\u20138.8) million people, were living with LTBI in 2015. Estimated LTBI prevalence among US-born persons was 1.0% (CI: 1.0%\u20131.1%) and among non-US-born persons was 13.9% (CI: 13.5%\u201314.3%). Among US-born persons, the highest LTBI prevalence was in persons aged \u226565 years (2.1%) and in persons of non-Hispanic Black race\/ethnicity (3.1%). Among non-US-born persons, the highest LTBI prevalence was estimated in persons aged 45\u201364 years (16.3%) and persons of Asian and other racial\/ethnic groups (19.1%).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Our estimations of the prevalence of LTBI by medical risk factors and demographic characteristics for each state could facilitate planning for testing and treatment interventions to eliminate TB in the United States. Our back-calculation method feasibly estimates untreated LTBI prevalence and can be updated using future TB disease case counts at the state or national level.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0249012","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T18:37:18Z","timestamp":1617302238000},"page":"e0249012","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":34,"title":["State-level prevalence estimates of latent tuberculosis infection in the United States by medical risk factors, demographic characteristics and nativity"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0478-3220","authenticated-orcid":true,"given":"Ali","family":"Mirzazadeh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James G.","family":"Kahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-068X","authenticated-orcid":true,"given":"Maryam B.","family":"Haddad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7418-6456","authenticated-orcid":true,"given":"Andrew N.","family":"Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3024-1940","authenticated-orcid":true,"given":"Suzanne M.","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Readhead","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pennan M.","family":"Barry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Flood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Mermin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya B.","family":"Shete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"issue":"11","key":"pone.0249012.ref001","doi-asserted-by":"crossref","first-page":"286","DOI":"10.15585\/mmwr.mm6911a3","article-title":"Tuberculosis\u2014United States, 2019","volume":"69","author":"NG Schwartz","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"pone.0249012.ref002","unstructured":"CDC. 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