Anemia Burden, Types, and Severity Among the Kurdish Population: Insights From the Zakho Premarital Program

Background Anemia is a major global public health concern with marked regional and global variation; however, data on its prevalence, severity, and subtypes among the Kurdish population in Zakho, Kurdistan Region of Iraq, are limited. This study aimed to determine the prevalence, severity, and morphological subtypes of anemia among Kurdish individuals undergoing premarital screening in Zakho. Methods A prospective cross‐sectional study was conducted at the Premarital Screening Centre of Zakho Emergency Teaching Hospital from March 2022 to October 2024. A total of 5948 participants were enrolled. Their sociodemographic data and blood samples were collected for complete blood count parameters. Anemia prevalence and its severity were classified according to the WHO criteria and morphologically subtyped based on red cell indices. Results Anemia was detected in 505 participants (8.49%), predominantly in females ( p < 0.001), especially aged 18–39 years. No significant differences were observed by the religious group. Mild anemia occurred in 300 cases (5.04%), moderate in 202 (3.40%), and severe in 3 (0.05%). However, no significant difference in anemia severity was observed by sex ( p = 0.072). Hypochromic microcytic anemia was most frequent (408 cases, 6.86%), mainly in females ( p < 0.001). In comparison, normochromic normocytic anemia was identified in 96 cases (1.61%), more often in males, while macrocytic anemia was rarely detected in only one male (0.02%). There is a significant sex‐based difference in anemia subtypes ( p < 0.001). Conclusion The overall anemia prevalence in Zakho represents a mild public health concern, but the high proportionately affected young reproductive age group females have a significant public health concern and predominantly of mild to moderate severity. The high prevalence of hypochromic microcytic anemia in females and normochromic anemia in males suggests that iron deficiency, hemoglobinopathy, and anemia of chronic disorders are the primary underlying causes.