Knowledge, attitudes and influencing factors regarding organ donation and transplantation among medical students and doctors in Malawian tertiary hospitals: a cross-sectional study

Background

Organ transplantation is a crucial treatment for end-stage organ diseases. However, it remains an unmet need in Malawi and much of sub-Saharan Africa. Medical personnel play a significant role in communicating with patients and their families about organ donation and transplantation (ODT), making their knowledge and attitudes vital in the ODT process. We aimed to assess the knowledge and attitudes toward ODT among medical students and doctors in Malawian tertiary hospitals.

Methods

A questionnaire on knowledge and attitudes toward ODT was administered to all doctors at Queen Elizabeth Central Hospital and Kamuzu Central Hospital, and 4th and 5th-year students from Kamuzu University of Health Sciences between November 2022 and May 2023.

Results

A total of 306 participants completed the questionnaire, with a 99% response rate, of which 169 (55.0%) were doctors. Most participants were male at 188 (61.4%), with a male-to-female ratio of 1.6:1. Most of the participants were aged between 18 and 30 years of age at 213 (69.8%). Overall, 57.8% had a higher knowledge regarding ODT. There was no significant association between knowledge and cadre of doctors or year of study of the students after adjusting for all significant confounding factors. The majority (79%) of the participants had a negative attitude toward ODT. Attitudes toward ODT were significantly associated with participants’ religious affiliations such that those who did not wish to disclose their religion were 2.78 times more likely to have a positive attitude towards organ transplant than Christians (Adjusted Odds ratio 2.78, 95% CI [1.02,7.56]).

Conclusion

Overall, most participants were aware of ODT. Specialist doctors demonstrated significantly greater self‑reported awareness of ODT compared with medical students; no significant differences were observed between non‑specialist doctors and medical students. However, the overall majority held a negative attitude towards it. These attitudes were marginally influenced by religious beliefs. Qualitative studies are recommended to further examine the impact of religion, among others, on the attitudes of doctors and students towards ODT.