{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T06:47:29Z","timestamp":1782283649564,"version":"3.54.5"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic strained healthcare worker (HCW) mental health worldwide. In Tajikistan, limited data on HCW mental health limit understanding of the pandemic\u2019s effect on HCWs. We assessed the prevalence of anxiety and depression and examined associated occupational and psychosocial factors among HCWs who provided care during the COVID-19 pandemic from March 2020 to December 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional survey of HCWs from three hospitals and three polyclinics in Khujand, Tajikistan, during July\u2013August 2022. Participants were asked to recall their experiences from March 2020 through December 2021. Using systematic sampling, 400 HCWs who had provided care to patients with COVID-19 were interviewed in person. Moderate-to-severe anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale (cut-off scores of \u226511). Associations with anxiety and depression were examined using multivariable mixed-effects models adjusting for hospital clustering.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 400 participants, 69% had depression, 26% anxiety, and 17% both. Most participants were female (82%), nurses (67%), and had more than 10\u202fyears of work experience (51%). Anxiety was independently associated with female sex [adjusted prevalence odds ratio (aPOR)\u202f=\u202f3.2; 95% confidence interval (CI): 1.5\u20136.6], work fatigue (aPOR\u202f=\u202f2.4; 95% CI: 1.0\u20135.7), prior COVID-19 (aPOR\u202f=\u202f2.2; 95% CI: 1.3\u20133.9), working \u226512-h shifts vs. less (aPOR\u202f=\u202f1.9; 95% CI: 1.1\u20133.2), and family separation during the pandemic (aPOR\u202f=\u202f1.8; 95% CI: 1.0\u20133.2). Depression was associated with having had severe COVID-19 vs. mild or none (aPOR\u202f=\u202f4.0; 95% CI: 1.4\u201311.8), nurse vs. physician role (aPOR\u202f=\u202f3.5; 95% CI: 1.7\u20137.2), and work-related social avoidance vs. none (aPOR\u202f=\u202f1.6; 95% CI: 1.0\u20132.6).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HCWs in Tajikistan experienced a substantial burden of anxiety and depression during the COVID-19 pandemic. These findings were used to inform mental health trainings, screening programs, and workplace interventions including counseling access, respite programs, and improved staffing patterns to support healthcare workers experiencing anxiety and depression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1875324","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:55:13Z","timestamp":1782280513000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anxiety and depression among healthcare workers during the COVID-19 pandemic in Khujand, Tajikistan"],"prefix":"10.3389","volume":"14","author":[{"given":"Jamila","family":"Silemonshoeva","sequence":"first","affiliation":[{"name":"Central Asia Advanced Field Epidemiology Training Program","place":["Dushanbe, Tajikistan"]},{"name":"Asfendiyarov Kazakh National Medical University","place":["Almaty, Kazakhstan"]},{"name":"Center of State Sanitary and Epidemiological Service of Sughd Region","place":["Khujand, Tajikistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Horth","sequence":"additional","affiliation":[{"name":"Central Asia Advanced Field Epidemiology Training Program","place":["Dushanbe, Tajikistan"]},{"name":"United States Centers for Disease Control and Prevention, Central Asia Office","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulfiya","family":"Tilloeva","sequence":"additional","affiliation":[{"name":"State Institution \"Municipal Disinfection Station\"","place":["Dushanbe, Tajikistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirzoda","family":"Abduholik","sequence":"additional","affiliation":[{"name":"Ministry of Health and Social Protection of Population of the Republic of Tajikistan","place":["Dushanbe, Tajikistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmond F","family":"Maes","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University","place":["Atlanta, GA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalkar","family":"Adambekov","sequence":"additional","affiliation":[{"name":"United States Centers for Disease Control and Prevention, Central Asia Office","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Millman","sequence":"additional","affiliation":[{"name":"United States Centers for Disease Control and Prevention, Central Asia Office","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilyara","family":"Nabirova","sequence":"additional","affiliation":[{"name":"Central Asia Advanced Field Epidemiology Training Program","place":["Dushanbe, Tajikistan"]},{"name":"Asfendiyarov Kazakh National Medical University","place":["Almaty, Kazakhstan"]},{"name":"United States Centers for Disease Control and Prevention, Central Asia Office","place":["Almaty, Kazakhstan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/S2213-2600(21)00068-0","article-title":"COVID-19: a heavy toll on health-care workers","volume":"9","author":"Mehta","year":"2021","journal-title":"Lancet Respir Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e003097","DOI":"10.1136\/bmjgh-2020-003097","article-title":"Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review","volume":"5","author":"Bandyopadhyay","year":"2020","journal-title":"BMJ Glob Health"},{"key":"ref3","volume-title":"The Impact of COVID-19 on Health and Care Workers: A Closer Look at 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Prevalence and determinants of depression among healthcare workers during the COVID-19 pandemic in Khujand, Tajikistan, 2022","volume":"10","author":"Silemonshoeva","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s40359-016-0120-9","article-title":"Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review","volume":"4","author":"Brooks","year":"2016","journal-title":"BMC Psychol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12889-020-10070-3","article-title":"A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being","volume":"21","author":"De Kock","year":"2021","journal-title":"BMC Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e2134315","DOI":"10.1001\/jamanetworkopen.2021.34315","article-title":"Experiences of work-family conflict and mental health symptoms by gender among physician parents during the COVID-19 pandemic","volume":"4","author":"Frank","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"273","DOI":"10.3934\/publichealth.2024014","article-title":"COVID-19 pandemic? 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