Childhood tuberculosis and risk of frailty in later life: evidence from a nationally representative study in Brazil

Evelyn Lepka De Lima; Márlon Juliano Romero Aliberti

doi:10.1093/infdis/jiaf563

Childhood tuberculosis and risk of frailty in later life: evidence from a nationally representative study in Brazil

J Infect Dis. 2025 Nov 5:jiaf563. doi: 10.1093/infdis/jiaf563. Online ahead of print.

Authors

Evelyn Lepka De Lima^{1

2

3}, Márlon Juliano Romero Aliberti^{2

3

4}

Affiliations

¹ Tuberculosis Control Program, Municipal Health Secretariat of Guarujá City, Guarujá, São Paulo, Brazil.
² Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America.
³ Laboratório de Investigação Médica em Envelhecimento (LIM-66), Serviço de Geriatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil.
⁴ Research Institute, Hospital Sirio-Libanes, São Paulo, Brazil.

PMID: 41206432
DOI: 10.1093/infdis/jiaf563

Abstract

The life-course impact of childhood tuberculosis (TB)-including its connection to frailty-remains poorly understood. We analyzed 8,459 adults ≥50 years in ELSI-Brazil (2015-2016), including 74 with self-reported TB before age 15. Frailty (phenotype) was assessed and compared using Poisson models before and after propensity-score matching (1:4; 283 controls); mediation tested chronic obstructive pulmonary disease (COPD). Frailty was more frequent with childhood TB (23.0% vs. 8.8%; p=0.001). After matching, childhood TB was associated with higher frailty prevalence (PR 2.52; 95% CI 1.43-4.44); mediation through COPD was small and not statistically significant. Findings support a life-course approach to TB care.

Keywords: Post-tuberculosis; chronic obstructive pulmonary disease; frailty; life-course approach.

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