Assessment of willingness to donate eyes among patients attending ophthalmology and ENT clinics At Muhimbili National Hospital

Abstract

ABSTRACT Background: Eye donation is an act of high-level kindness to humanity and the society, which involves the will of a person to consent for removing his/her, eyes from the body after death. This consent can be signed by the donor before his/her death by writing a will to be an eye donor (pledge eyes), but also the permission can be given by a close relative of the deceased, if he/she did not deny to be a donor while still alive. Donated eyes are used to treat patients with blindness due to corneal diseases, by corneal transplant. Eyes which cannot be used for corneal transplant can be used for research and teaching purposes. Willingness to donate eyes depends on awareness about importance of eye donation within the population. Therefore, it is important to know the factors associated with the willingness to donates eyes in order to have sustainable local corneal transplant services. Objective: The aim of this study was to assess willingness to donate eyes among patients attending the Ophthalmology and ENT (Ear, Nose and Throat) clinics in Muhimbili National Hospital (MNH)”. Methodology: A cross sectional descriptive hospital based study with quantitative and qualitative approaches was done from July to December 2017. Study participants for quantitative part were selected by systematic random sampling technique. A predesigned pretested questionnaire was used and a face to face interview was conducted to correct data for quantitative part of the study. Qualitative data were collected through focus group discussion (FGD) and study participants were selected by purposive sampling technique. Data analysis: Quantitative data analysis was performed using SPSS version.20; Chi-square (χ2) and t tests were performed and multivariate analysis was done to test association between variables. Frequencies and proportions were selected according to level of measurement. P value of < 0.05 was estimated as statistically significant. Data were summarized in tables, pie and bar charts for easy presentation. Systematic thematic analysis was used for qualitative data, whereby all similar themes were grouped accordingly. Results: A total of 434 participants were enrolled in the study and the response rate was 100%. Majority were female (58.06%), 74.1% were from Dar es Salaam and 44.9% were in age group between “18-33” years. One third (32.5%) of all respondents, were aware that eyes can be donated and 83.7% of them knew that donated eyes are used for corneal transplant. Only 13.5% know that consent for eye donation can be signed by a close relative of a deceased person. Willingness to donate eyes in this study was observed in 47.9% of all respondents. The main reason for willingness to donate eyes was to help a blind a person (64.2%). About 29.5% were willing to donate eyes because they will not need them after death and 6.3% were willing because it is a noble work. Perceived reasons for unwillingness were lack of information about eye donation (31.7%) while 24.7% were uncertain on the use of donated eyes and religious reasons composed 22.0%. Only 4.4% said that eye donation is against their culture. Willingness to donate eyes was associated with awareness (p=0.0001), sex (p=0.049) and religion (p=0.010). For all participants, 82.2% said eye donation services are important for the population and 45.1% of them think that to become an eye donor is a personal decision. Common perceived reasons for eye donation importance were that eye donation services can reduce the burden of blindness (83.5%) and Corneal transplant services would be cost effective (47.1%). Among participants who said that eye donation services are not important, 53.5% of them think that eye donation is a kind of organ trafficking. Eight themes emerged from FGD: Helping others, Religion, fear, death and body, organ trafficking, community education, benefits of eye donation, decision making about becoming an eye donor. Conclusion: The present study showed that majority of the participants was not aware of eye donation. However, willingness to donate eyes was seen in nearly a half of study participants and most of the participants think that eye donations services are important for the population. Negative perception about eye donation was associated with lack of information, cultural beliefs, religious beliefs as well as personal fear. Therefore, raising awareness about eye donation through community education is important to raise willingness to donate eyes.