Prevalence and Determinants of Anemia Among Women of Reproductive Age and Children Under Five in Tajikistan

<b>Introduction:</b> Anemia is a global public health concern affecting mainly women of reproductive age (WRA) and preschoolers (PSC, 6-59 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. <b>Methods:</b> 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 6-59 months in pairs (mother-PSC 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). <b>Results:</b> 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 < 24 months, and low ferritin were associated with increased odds of anemia. <b>Conclusions</b>: 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.