YOUTH aged 15–24 years play a smaller role in spreading tuberculosis (TB) within households compared to adults, according to a new study.
Researchers conducted a household cohort study in Lima, Peru, between 2009 and 2012, enrolling more than 15,000 participants. They followed index patients diagnosed with TB and their household contacts for 12 months, while also analyzing bacterial genetic links using whole-genome sequencing. The goal was to understand whether youth serve as significant drivers of TB transmission in household settings.
The findings revealed that children exposed to youth index patients had a 23% lower risk of prevalent TB infection compared with those exposed to adult index patients. Among index-secondary patient pairs, 62% of youth-related cases were genetically linked, compared with 72% for adult-related cases, though this difference was not statistically significant. Importantly, at 12-month follow-up, both child and youth contacts had substantially lower incident infection risk than adult contacts.
The results suggest that youth not only transmit less TB than adults but are also less susceptible to new infection within households. The authors concluded that while household exposure is a key driver of transmission, youth may be more relevant to TB spread in community or social settings rather than at home.
For U.S. clinicians, these insights reinforce the importance of tailoring TB prevention strategies by age group. Adults remain the primary household transmitters, while youth populations may require more focus in school, workplace, or social health interventions.
Reference: Brooks MB et al. The role of youths in within-household tuberculosis transmission: a household contact cohort study. Clin Infect Dis. 2025;ciaf490.
