{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:38:54Z","timestamp":1790811534336,"version":"4.1.0"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Aga Khan Foundation, Geneva, Switzerland"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: Anemia is a global public health concern affecting mainly women of reproductive age (WRA) and preschoolers (PSC, 6\u201359 months) due to their higher demand for iron. The etiology of anemia is multifactorial, and nutritional anemia is the most common type worldwide and is predominantly due to deficiencies in iron, vitamin B12, and folate. This study aimed to assess the associated factors, etiology, and prevalence of anemia among WRA and preschoolers in the Gorno-Badakhshan Autonomous Oblast (GBAO) region in Tajikistan. Methods: We conducted a cross-sectional study in the GBAO region of Tajikistan between April 2021 and September 2021, enrolling 500 non-pregnant WRA and 500 children aged 6\u201359 months in pairs (mother\u2013PSC dyads) from six districts of the GBAO region. The survey was administered through a structured questionnaire at the household level, and information was collected on sociodemographic characteristics, reproductive history, dietary intake, nutritional status, and maternal factors. Blood and stool samples were also collected for micronutrient deficiencies and helminthic infections. Data analysis began with univariate analysis, followed by multivariate logistic regression in Stata (version 18). Results: Biochemical assessment of 473 WRA and 390 preschoolers was carried out; 17.3% of WRA were anemic, and 15.4% of PSC were anemic. Anemia prevalence was 17.3% among WRA and 15.4% among PSC. Among women, low ferritin and elevated serum transferrin receptor (sTfR) levels were associated with higher odds of anemia, whereas overweight status, higher gravidity, and vitamin B12 deficiency were associated with lower odds. Among children, low maternal education, maternal anemia, age &lt; 24 months, and low ferritin were associated with increased odds of anemia. Conclusions: Anemia prevalence in GBAO was substantially lower than reported in the 2016 national survey, potentially reflecting methodological and contextual differences. Findings highlight iron deficiency as a dominant contributor, particularly in young children, underscoring the need for context-specific maternal and child nutrition interventions.<\/jats:p>","DOI":"10.3390\/nu18050752","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T13:58:03Z","timestamp":1772114283000},"page":"752","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and Determinants of Anemia Among Women of Reproductive Age and Children Under Five in Tajikistan"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4192-8406","authenticated-orcid":false,"given":"Sajid B.","family":"Soofi","sequence":"first","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Department of Pediatrics & Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-3113","authenticated-orcid":false,"given":"Imran A.","family":"Chauhadry","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Department of Pediatrics & Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0079-3330","authenticated-orcid":false,"given":"Imtiaz","family":"Hussain","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Department of Pediatrics & Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Atif","family":"Habib","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-1687","authenticated-orcid":false,"given":"Muhammad","family":"Umer","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9627-2662","authenticated-orcid":false,"given":"Shabina","family":"Ariff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics & Child Health, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lailo","family":"Kurbonmamadova","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation, Dushanbe 734003, Tajikistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nizoramo","family":"Ramikhudoeva","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation, Dushanbe 734003, Tajikistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roziya","family":"Buribekova","sequence":"additional","affiliation":[{"name":"Aga Khan Health Services, Dushanbe 734025, Tajikistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminah","family":"Jahangir","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation, 1202 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Hudspeth","sequence":"additional","affiliation":[{"name":"Aga Khan Foundation, 1202 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-599X","authenticated-orcid":false,"given":"Zulfiqar A.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Institute of Global Health & Development, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Departments of Paediatrics, Nutritional Sciences & Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Baldi, A., and Pasricha, S.-R. (2022). Anaemia: Worldwide Prevalence and Progress in Reduction. Nutritional Anemia, Springer.","DOI":"10.1007\/978-3-031-14521-6_1"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ali, S.A., Abbasi, Z., Shahid, B., Moin, G., Hambidge, K.M., Krebs, N.F., Westcott, J.E., McClure, E.M., Goldenberg, R.L., and Saleem, S. (2020). Prevalence and determinants of anemia among women of reproductive age in Thatta Pakistan: Findings from a cross-sectional study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0239320"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Hakizimana, D., Nisingizwe, M.P., Logan, J., and Wong, R. (2019). Identifying risk factors of anemia among women of reproductive age in Rwanda\u2014A cross-sectional study using secondary data from the Rwanda demographic and health survey 2014\/2015. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-8019-z"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Msemo, O.A., Bygbjerg, I.C., M\u00f8ller, S.L., Nielsen, B.B., \u00d8dum, L., Perslev, K., A Lusingu, J.P., A Kavishe, R., Minja, D.T.R., and Schmiegelow, C. (2018). Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0208413"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Petry, N., Jallow, B., Sawo, Y., Darboe, M.K., Barrow, S., Sarr, A., Ceesay, P.O., Fofana, M.N., Prentice, A.M., and Wegm\u00fcller, R. (2019). Micronutrient deficiencies, nutritional status and the determinants of anemia in children 0\u201359 months of age and non-pregnant women of reproductive age in the Gambia. Nutrients, 11.","DOI":"10.3390\/nu11102275"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"402S","DOI":"10.3945\/ajcn.116.142323","article-title":"Predictors of anemia in preschool children: Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) project","volume":"106","author":"Aaron","year":"2017","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e018007","DOI":"10.1136\/bmjopen-2017-018007","article-title":"Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: Analysis of national-level secondary survey data","volume":"7","author":"Khan","year":"2017","journal-title":"BMJ Open"},{"key":"ref_8","unstructured":"(2014). WHOTW 2025: Anaemia Policy Brief."},{"key":"ref_9","unstructured":"World Health Organization (2021). WHO Global Anaemia Estimates."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1016\/S2214-109X(13)70001-9","article-title":"Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995\u20132011: A systematic analysis of population-representative data","volume":"1","author":"Stevens","year":"2013","journal-title":"Lancet Glob. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1038\/s41591-021-01498-0","article-title":"Anemia prevalence in women of reproductive age in low-and middle-income countries between 2000 and 2018","volume":"27","author":"Kinyoki","year":"2021","journal-title":"Nat. Med."},{"key":"ref_12","unstructured":"World Bank (2025, August 01). Prevalence of Anemia Among Women of Reproductive Age (% of Women Ages 15\u201349)\u2014Kazakhstan. Available online: https:\/\/data.worldbank.org\/indicator\/SH.ANM.ALLW.ZS?locations=KZ."},{"key":"ref_13","unstructured":"World Bank (2025, August 01). Prevalence of Anemia Among Children (% of Children Ages 6\u201359 Months)\u2014Uzbekistan. Available online: https:\/\/data.worldbank.org\/indicator\/SH.ANM.CHLD.ZS?locations=UZ."},{"key":"ref_14","unstructured":"UNICEF Tajikistan (2025, August 01). National Nutrition Survey in Tajikistan 2016 [PDF]. UNICEF. Available online: https:\/\/www.unicef.org\/tajikistan\/media\/491\/file\/National%20Nutrition%20Survey%20in%20Tajikistan%202016%20.pdf."},{"key":"ref_15","unstructured":"World Health Organization (2025, August 01). Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-NMH-NHD-MNM-11.1."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1017\/S1368980012001267","article-title":"Relationship between markers of inflammation and anaemia in children of Papua New Guinea","volume":"16","author":"Shinoda","year":"2013","journal-title":"Public Health Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"201","DOI":"10.7861\/clinmed.2022-0436","article-title":"Anaemia of acute inflammation: A higher acute systemic inflammatory response is associated with a larger decrease in blood haemoglobin levels in patients with COVID-19 infection","volume":"23","author":"Crooks","year":"2023","journal-title":"Clin. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"458S","DOI":"10.1093\/ajcn\/nqaa141","article-title":"Adjusting iron and vitamin A status in settings of inflammation: A sensitivity analysis of the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) approach","volume":"112","author":"Namaste","year":"2020","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Habib, M.A., Black, K., Soofi, S.B., Hussain, I., Bhatti, Z., Bhutta, Z.A., and Raynes-Greenow, C. (2016). Prevalence and predictors of iron deficiency anemia in children under five years of age in Pakistan, a secondary analysis of national nutrition survey data 2011\u20132012. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0155051"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Khan, J.R., Awan, N., and Misu, F. (2016). Determinants of anemia among 6\u201359 months aged children in Bangladesh: Evidence from nationally representative data. BMC Pediatr., 16.","DOI":"10.1186\/s12887-015-0536-z"},{"key":"ref_21","first-page":"164","article-title":"Review on iron and its importance for human health","volume":"19","author":"Abbaspour","year":"2014","journal-title":"J. Res. Med. Sci. Off. J. Isfahan Univ. Med. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1017\/S1368980015002050","article-title":"Characterisation of anaemia and associated factors among infants and pre-schoolers from rural India","volume":"19","author":"Nair","year":"2016","journal-title":"Public Health Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Habib, A., Kureishy, S., Soofi, S., Hussain, I., Rizvi, A., Ahmed, I., Ahmed, K.M., Achakzai, A.B.K., and Bhutta, Z.A. (2023). Prevalence and Risk Factors for Iron Deficiency Anemia among Children under Five and Women of Reproductive Age in Pakistan: Findings from the National Nutrition Survey 2018. Nutrients, 15.","DOI":"10.3390\/nu15153361"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1590\/2176-9451.19.4.027-029.ebo","article-title":"How sample size influences research outcomes","volume":"19","author":"Faber","year":"2014","journal-title":"Dent. Press J. Orthod."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/5\/752\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T14:08:24Z","timestamp":1772114904000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/5\/752"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["nu18050752"],"URL":"https:\/\/doi.org\/10.3390\/nu18050752","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]}}}