Published in PLOS One on 2026-07-10, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. HealthSignal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Maua Nyagawa, Baraka Morris, Suleiman Chombo, Francis Furia
Source: PLOS One • DOI 10.1371/journal.pone.0351952
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
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.
Introduction
Organ transplantation is a life-saving treatment involving the surgical replacement of failing organs using donated healthy ones. The success of a transplantation program depends on the sustainable availability of organs [1,2]. Unfortunately, there is a global scarcity of donor organs, while the demand is increasing. Organs are available for less than 10% of all needy individuals, translating into an organ shortage crisis [1]. In the United States, the kidney transplantation waiting list grew by 18% between 2020 and 2022, leading to longer waiting times and increased patient morbidity and mortality [2]. Sub-Saharan Africa (SSA) bears the world’s highest CKD burden (prevalence 10–20% stages 1–5), with end stage renal disease (ESRD) incidence 100–200 pmp but prevalence <50 pmp due to treatment gaps [3,4]. Likewise, SSA is the region with the lowest availability of transplant services for the treatment of CKD, which results in high mortality [3,4]. Dialysis mortality reaches 31% in SSA (17% Tanzania), driven by inadequate hemodialysis (HD) quality [5,6]. Annual dialysis costs average $18,741 (South Africa $39,102; Tanzania $37,261) equals to>20x GDP/capita for most countries, causing catastrophic expenditures where insurance covers only <8% of the population [7,8]. By 2030, > 70% global ESRD patients will be African [8]. Tanzania exemplifies this crisis with CKD prevalence 7–15% general population, and 83.7% hospitalizations [9]. Currently the country has 3231 patients on dialysis across 47 HD units with 649 machines [10].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Maua Nyagawa, Baraka Morris, Suleiman Chombo, Francis Furia. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by HealthSignal. The researchers are the authors of the source study, not members of HealthSignal’s staff.
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