People with prior tuberculosis have accelerated frailty and differential survival into older age: a cross-sectional analysis in Southern Africa.

Coleman, M; Manyara, A; Calderwood, C J; de Wilton, A; Madela, E I Y; Wilson, H; Burton, A; Gates, L et al. · J Infect Dis · 2026

cross_sectional · Level IV

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Abstract

Post-tuberculosis disability impairs quality-of-life, yet chronic functional outcomes for tuberculosis survivors remain under-characterized. This cross-sectional sub-study (2022-2024) estimated Fried frailty phenotype prevalence among adults aged ≥40 years with self-reported prior tuberculosis in South Africa and Zimbabwe, compared to those with no tuberculosis history. Survivor bias was evaluated using historic WHO data. After adjusting for age, sex, education, and HIV, prior tuberculosis was associated with twice the odds of frailty (OR=2.06, 95%CI 1.38-3.03, p=0.001), and worse survival into older age. As longevity increases in Southern Africa, healthy-ageing interventions for tuberculosis survivors could improve function and survival into older age.