Willingness toward kidney donation among patients’ relatives at Muhimbili National Hospital, Dar es Salaam, Tanzania: A cross-sectional study

Abstract

BACKGROUND: Kidney transplantation provides superior long-term survival and quality of life over dialysis for patients with end-stage kidney disease; however, its use is limited by the availability of donors. In Tanzania, only living-related kidney transplantation has been performed since 2017 at Muhimbili National Hospital (MNH). Success relies on donor readiness, yet little is known about public willingness to donate. AIM: To assess willingness of patients' relatives to donate kidneys at MNH. METHODS: Cross-sectional study design among 424 in-patient relatives at MNH from May to June 2023. Systematic random sampling was used to recruit participants. Data were collected using a questionnaire comprised of inquiries on socio-demographics, knowledge, attitudes, and willingness to donate and analyzed using the Stata 18 software. Frequency distribution tables summarized descriptive statistics. Modified Poisson regression with robust variance identified factors associated with willingness. RESULTS: Of the 424 participants, Mean age 36 ± 11 years; 240(56.6%) female, 362(85.4%) urban, 400(94.3%) educated. While 361(85%) heard of organ donation, only 32(7.5%) had adequate knowledge, 289(68.2%) positive attitude, 200(47.2%) willing to donate. Age 35-44 years (aRR = 0.69 [95% CI: 0.49-0.99], p = 0.046), female gender (aRR = 0.82 [95% CI: 0.67-0.99], p = 0.042), informal traders/farmers (aRR = 0.77 [95% CI: 0.60-0.99], p = 0.041) had lower willingness versus counterparts. Positive attitude showed 74% higher likelihood (aRR = 1.74 [95% CI: 1.31-2.30], p < 0.001). CONCLUSION: Low kidney donation willingness was influenced by attitude, age, gender, and occupation. Majority of the participants lacked adequate knowledge. Educational programs needed to improve knowledge, attitude, and willingness.