DYNAMICS OF PRIMARY ANEMIA MORBIDITY AMONG THE POPULATION OF KASHKADARYA REGION (2017–2019)

PRINCIPAL ISSUES OF SCIENTIFIC RESEARCH AND MODERN EDUCATION Vol. 4 No.6 (2025) 93 DYNAMICS OF PRIMARY ANEMIA MORBIDITY AMONG THE POPULATION OF KASHKADARYA REGION (2017–2019) Marguba A. Togaeva1, Hasan.N.Kholmatov, Nargiz.E.Kuchkarova, Fayyoza Kh.Khujanazarova Department of General Methodological Sciences, Faculty of Digital Technologies, University of Economics and Pedagogy, Karshi 180100, Uzbekistan; [email protected] Abstract This study provides a comprehensive epidemiological analysis of primary anemia morbidity across the districts of Kashkadarya Region, Uzbekistan, during the years 2017–2019. The objective was to identify spatial and temporal variations in anemia incidence per 100,000 population and to interpret the underlying sociobiological factors contributing to these differences. Data revealed a striking heterogeneity across the fifteen administrative units of the region. Chiroqchi and Kitob districts demonstrated abnormally high incidence rates in 2017, while certain rural districts such as Mirishkor and Dehqonobod experienced considerable fluctuations across the studied years. The findings suggest that the anemia burden is shaped by a combination of nutritional inadequacies, healthcare disparities, and environmental determinants. The study underscores the necessity for districtspecific strategies that integrate preventive, diagnostic, and educational interventions to mitigate anemia prevalence sustainably. Keywords: Anemia, epidemiology, morbidity rate, Kashkadarya, Uzbekistan, public health, regional analysis, temporal trends. 1. Introduction PRINCIPAL ISSUES OF SCIENTIFIC RESEARCH AND MODERN EDUCATION Vol. 4 No.6 (2025) 94 Anemia represents one of the most pervasive public health challenges globally, affecting an estimated 1.6 billion individuals, particularly among women of reproductive age and children under five. Despite substantial global progress in nutrition and healthcare access, anemia remains endemic in several lowand middle-income nations due to multifactorial causes including iron deficiency, chronic infections, and socio-economic inequality. In Uzbekistan, anemia prevalence exhibits regional disparities driven by differences in diet composition, healthcare accessibility, and ecological conditions. The Kashkadarya region, situated in the south-central part of the country, is characterized by semi-arid climatic conditions and a mixed agro-industrial economy. These attributes exert both direct and indirect effects on the nutritional profile of the population. Previous epidemiological assessments have often generalized national trends without sufficient attention to district-level variability. Consequently, the present study aims to investigate the spatial and temporal dynamics of anemia morbidity within Kashkadarya Region over a three-year period (2017–2019), focusing on local disparities, underlying determinants, and potential policy implications. 2. Materials and Methods 2.1. Data Collection The study utilizes official health statistics obtained from the regional public health department, reporting the number of newly diagnosed anemia cases per 100,000 inhabitants for each of the fifteen administrative units of Kashkadarya Region over the years 2017, 2018, and 2019. The dataset encompasses both urban centers (Qarshi and Shahrisabz cities) and thirteen rural districts. 2.2. Analytical Approach Descriptive and inferential analyses were conducted using Microsoft Excel and Python libraries (Pandas and Matplotlib). The values were normalized to PRINCIPAL ISSUES OF SCIENTIFIC RESEARCH AND MODERN EDUCATION Vol. 4 No.6 (2025) 95 ensure comparability across districts. Missing data (for example, Shahrisabz City in 2017) were not imputed but treated as absent to maintain data integrity. A multi-line chart was constructed to visualize inter-district temporal changes in anemia morbidity. This graphical approach allows a comparative interpretation of trends across administrative units. 2.3. Interpretation Framework The interpretation incorporated contextual variables such as population density, agricultural activity, socio-economic development, and healthcare infrastructure. The conceptual framework aligns with WHO recommendations for anemia surveillance, emphasizing regional-level differentiation for public health planning. 3. Results The data revealed considerable variation in anemia morbidity rates among different districts. In 2017, the highest rates were observed in Chiroqchi (20891.7 per 100,000) and Kitob (18785.0), while the lowest were recorded in Mirishkor (909.9). In 2018, rates decreased sharply in most districts, suggesting improved nutritional and healthcare conditions. However, by 2019, an increase was again noted, particularly in Muborak, Shahrisabz, and Qamashi districts. The overall regional average showed a U-shaped dynamic, indicating partial reversal of progress achieved in 2018. PRINCIPAL ISSUES OF SCIENTIFIC RESEARCH AND MODERN EDUCATION Vol. 4 No.6 (2025) 96 The data revealed extensive inter-district variability. Table 1 (not shown here) demonstrates that in 2017, Chiroqchi District exhibited the highest anemia incidence rate (20,891.7 per 100,000), followed closely by Kitob District (18,785.0). Conversely, Mirishkor District recorded the lowest rate (909.9). The regional average stood at approximately 8,995.0 per 100,000 in 2017. Anemia dynamics Kashkadarya 2017-2019 PRINCIPAL ISSUES OF SCIENTIFIC RESEARCH AND MODERN EDUCATION Vol. 4 No.6 (2025) 97 A sharp overall decline was recorded in 2018, with most districts reporting substantial reductions. This decline might reflect improvements in diagnostic precision and early preventive measures initiated during that period. However, a resurgence of cases occurred in 2019, particularly in Muborak District (7,365.3), Shahrisabz District (4,626.0), and Nishon District (4,048.6). 4. District-Level Analysis Qarshi City: The capital of the region displayed a relatively stable but moderate incidence pattern. The 2017 value of 1,024.6 declined dramatically in 2018 (185.8), possibly due to diagnostic reporting changes, and increased again to 656.7 in 2019. Shahrisabz City: Data for 2017 are missing; however, a high incidence rate in 2018 (4,041.0) and 2019 (4,255.6) indicates urban-specific anemia prevalence, possibly influenced by dietary transitions and population density. Chiroqchi and Kitob Districts: Both districts exhibited extraordinarily high rates in 2017, declining sharply thereafter. These anomalies suggest potential overreporting or localized epidemic phenomena related to iron-deficiency clusters or data collection inconsistencies. Qamashi and Koson Districts: The anemia rates in these areas were persistently elevated across all three years, reflecting possible nutritional deficiencies or limited healthcare outreach programs. Muborak District: An upward trend culminating in 2019 positions Muborak as one of the high-risk zones, warranting immediate public health intervention. Kasbi and G‘uzor Districts: Displayed the lowest incidence in 2019, possibly due to effective community health campaigns and agricultural dietary diversification. 5. Temporal Trend Interpretation The multi-line chart (see Figure 1) visually encapsulates these fluctuations, demonstrating significant cross-district divergence in 2017, convergence in 2018, PRINCIPAL ISSUES OF SCIENTIFIC RESEARCH AND MODERN EDUCATION Vol. 4 No.6 (2025) 98 and partial divergence again in 2019. The trend suggests episodic health program effects rather than sustained improvement. Environmental determinants such as soil mineral composition, water salinity, and crop type (cotton dominance) may influence iron bioavailability in regional diets. Furthermore, socio-economic migration and gender-related disparities likely contribute to uneven anemia distribution. 6. Discussion The study’s findings align with previous reports (WHO, 2021; UNICEF, 2019) that anemia patterns in Central Asia are contextually driven by both biological and environmental determinants. In Kashkadarya, rapid economic transformations have not been accompanied by parallel improvements in dietary diversity, leading to persistent micronutrient deficiencies. The temporal decline observed in 2018 could be attributed to intensified preventive programs, yet the subsequent resurgence in 2019 underscores the lack of structural continuity in public health initiatives. The absence of uniform downward trends across districts indicates that national-level programs may require localized adaptation to ensure efficacy. This research also highlights the importance of data-driven regional health governance, wherein epidemiological evidence directly informs administrative decision-making. Integration of health data analytics into district planning could improve both preventive strategies and monitoring systems. 7. Conclusion The three-year analysis of primary anemia morbidity in Kashkadarya Region reveals substantial spatial and temporal heterogeneity. Although temporary improvements were noted, persistent high incidence rates in several districts confirm that anemia remains a significant public health concern. Effective mitigation requires a multi-dimensional approach incorporating nutritional education, iron fortification programs, maternal health monitoring, and PRINCIPAL ISSUES OF SCIENTIFIC RESEARCH AND MODERN EDUCATION Vol. 4 No.6 (2025) 99 district-level surveillance systems. Policymakers are urged to tailor interventions to the socio-economic and ecological characteristics of each district to ensure longterm reductions in anemia prevalence. References 1. World Health Organization. (2021). Global Report on Anemia. Geneva: WHO Press. 2. Ministry of Health of the Republic of Uzbekistan. (2020). National Health Statistics Yearbook. 3. UNICEF. (2019). Nutrition and Anemia in Central Asia: Regional Overview. 4. Guralnik, J. M., et al. (2004). Prevalence of anemia in persons 65 years and older. Blood, 104(8), 2263–2268. 5. Cappellini, M. D., & Motta, I. (2015). Anemia in clinical practice— definition and classification. Seminars in Hematology, 52(4), 261–269. 6. FAO. (2020). Dietary Iron Deficiency and Agricultural Determinants in Developing Regions. Rome: Food and Agriculture Organization. 7. Tursunov, A., et al. (2018). Public health challenges in Uzbekistan: trends in non-communicable diseases. Central Asian Journal of Health Policy, 6(2), 45–58. 8. Karimov, B., & Yusupov, M. (2017). Regional inequalities in healthcare access in Uzbekistan. Journal of Social and Economic Geography, 72(3), 112–127.