Prenatal and early-life exposure to the Great Chinese Famine increased the risk of tuberculosis in adulthood across two generations

Abstract

Significance Food system collapse incurs major societal costs that may extend across generations. The Great Chinese Famine—widely acknowledged as the largest famine in human history—was associated with tremendous short-term adverse health consequences, yet its long-term effect on infectious disease incidence has not been estimated. We conducted a cohort analysis of >1 million pulmonary tuberculosis (PTB) cases in a major center of ongoing transmission that experienced high famine mortality, finding a substantial burden of active PTB potentially attributable to the famine in the birth cohort that experienced prenatal and early-life exposure to famine, as well in their putative offspring. The Great Chinese Famine occurred >60 y ago, yet continues to contribute to the high PTB burden in China.