Which of the following are risk factors for developing TB?

• A. Immunosuppressed individuals
• B. Foreign-born persons
• C. Poor, underserved populations, homeless individuals, foreign-born persons, and immunosuppressed individuals
• D. None of the above

Answer: (C)

TB risk rises when the immune system is weakened and when living conditions or social factors increase exposure or hinder treatment. Immunosuppressed individuals are more likely to progress from latent infection to active TB because their body can’t contain the bacteria effectively. People born in countries with high TB prevalence are also at higher risk due to greater exposure and, in some cases, barriers to screening and treatment after arrival. Socioeconomic and housing factors—poverty, underserved populations, and homelessness—contribute by promoting crowded living conditions, poor nutrition, limited access to healthcare, and challenges completing therapy, all of which raise both infection risk and progression to active disease. Because these risks overlap and cover a wide range of people, the broad category that includes immunosuppressed individuals, foreign-born persons, and poor/underserved populations (including the homeless) best reflects who is at risk. Focusing on only one subgroup misses important contributing factors, and saying none of the above is inaccurate given these risk patterns.