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

Abstract

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. To assess willingness of patients' relatives to donate kidneys at MNH. 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. 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). 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.