The burden of tuberculosis in Latin America: Immunogenetic and socioepidemiological determinants.

Abstract

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major global health challenge and the leading cause of death from a single infectious agent. Despite diagnostic and therapeutic advances, the COVID-19 pandemic reversed progress in TB control, with a notable rise in incidence across Latin America. This region bears a disproportionate burden of the disease due to socioeconomic inequality, limited access to healthcare, and high rates of multidrug-resistant TB. Interactions among pathogen genetics, host susceptibility, immune response, and environmental determinants critically shape disease outcomes. Several key questions remain about the higher incidence of TB in the Americas, including the roles of genetic predisposition, environmental factors, and social determinants such as poverty and migration. Addressing these issues is essential to refining control strategies. Accordingly, this review provides an updated overview of TB in Latin America, integrating immunological, genetic, and socio-epidemiological perspectives that could be useful for future research and policy discussions toward more region-specific interventions against Mtb.