Childhood Tuberculosis and Risk of Frailty in Later Life: Evidence From a Nationally Representative Study in Brazil

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.