Factors Impacting Knowledge of Voluntary Blood Donation among Adult Residents of Mwanakwerekwe Ward in Zanzibar, Tanzania: Insights from a Community Survey

INTRODUCTION

The rise in human life expectancy and the implementation of new and aggressive surgical and therapeutic methods have increased the demand for blood and blood products in most countries. Blood, being the most commonly donated tissue in medical settings, serves as a crucial resource in numerous life-saving scenarios when utilized appropriately. Blood donation involves the voluntary extraction of blood from individuals for transfusions or the production of biopharmaceutical medications through a procedure known as fractionation [1,2]. Blood is so important to the human body that existence is completely impossible without it. Health systems worldwide need an adequate blood supply for their proper functioning. In Sub-Saharan Africa, blood donation holds considerable importance due to factors such as anemia resulting from malaria, sickle cell disease, road traffic accidents, and other causes [3].

Nonetheless, insufficient blood donation in Sub-Saharan Africa, including Tanzania, represents a significant public health challenge. Blood and its derivatives offer patients essential life-saving and therapeutic advantages [4]. They are indicated in several medical conditions, such as bleeding due to trauma, surgery and blood disorders, malignancies, and pregnancy complications, among others [5,6]. Blood transfusion support is needed in many acute situations, but patients who require transfusions often face delays in accessing a safe blood source [1,6].

Globally, 118.5 million units of blood donations are collected each year. However, 50% of these units come from developed countries, even though only 16% of the global population lives in developed countries [7]. This leaves 84% of the global population in non-developed countries facing chronic blood shortages for medical treatments. This shortage leads to unexpected deaths in African countries like Tanzania due to insufficient blood supplies in blood banks [7]. In India, approximately 15 million units of blood are required annually, but only around 11 million units are collected. Additionally, it is estimated that nearly 12,000 individuals perish daily due to the unavailability of high-quality blood [8].

In Africa, based on the 2009 national census of Kenya, blood donation in Nairobi has shown a decreasing trend over time. For instance, 38,808 units of blood were donated in 2006, whereas only 30,840 units were collected in 2009 [9,10].  According to the World Health Organization (WHO) Guidelines, a country needs at least 1% of the total population. However, with a Ugandan population of 34 million, it should ideally collect 340,000 units of blood, but only 220,000 were collected in 2014 because of many challenges [10-13].

In Tanzania, with a population of 54 million in 2020, the demand for blood stands at 540,000 units [5,14]. However, in 2016, less than 200,000 units were collected, resulting in a shortage of over 300,000 units [14]. Additionally, 15% of the collected units were deemed unfit for various reasons, reducing the available supply of usable blood [15]. Achieving health-related Millennium Development Goals, such as reducing child mortality, improving maternal health, and preventing HIV infection, hinges on ensuring equitable and universal access to safe blood [16,17]. According to the Ministry of Health of Zanzibar report published on World Blood Donor Day, June 14, 2022, Zanzibar is currently experiencing a significant shortage of blood within its healthcare facilities. The region collects an average of 10,000 units of blood annually, which falls short of the required demand of 18,000 units per year [18].

This study analyzed the factors impacting the community's knowledge of voluntary blood donation in Mwanakwerekwe Ward, Zanzibar. The insights, conclusions, and recommendations provided in this study are anticipated to enhance community members' willingness to engage in voluntary blood donation, thereby ensuring the community's safety in terms of blood supply.

PATIENTS AND METHODS

Area of study

This research was conducted at Mwanakwerekwe ward, located within Mwanakwerekwe Constituency in the West urban region in Zanzibar, approximately 7 kilometers from Zanzibar town. Mwanakwerekwe Constituency has two wards, Jitimai ward and Mwanakwerekwe ward.

Study design

A quantitative analytical cross-sectional study was conducted at Mwanakwerekwe ward in Zanzibar from March 20 to June 19, 2023.

Study population

The study included male and female adult community members at Mwanakwerekwe ward in Zanzibar.

Sampling procedures and sample size

Simple random sampling was used in the formed clusters of eight streets in which the respondents were allowed to take part in the study by picking a paper from an enclosed box, and any respondent who picked a paper written YES was invited to participate. This technique was used to ensure that each member of the targeted population had an equal and independent chance of being included in the study sample and to reduce bias. The sample size of 100 participants was calculated using Krejcie and Morgan formula with a confidence level of 95% = 1.96, a population size of 20,215 people, a population proportion of 85% = 0.85, and a margin error of 7% = 0.07.

Data collection and analysis

The researcher used a self-administered questionnaire. Data collected was analyzed using Statistical Package for Social Science (SPSS) version 26. Frequencies, percentages, and P-value for significant association.

Operational definitions of knowledge assessment

The level of knowledge is the understanding level of participants on the benefits, risks, and eligibility criteria of blood donation. Knowledge was assessed by 10 questions, each with 10 points to make 100%. Based on the total score, knowledge level on blood donation was categorized into adequate (≥50%) and inadequate (<50%).

RESULTS

The distribution of respondents by socio-demographic characteristics

The findings indicated that most of the participants, 33 (33.0%), were in the age range of 30-35 years, but only 14 (14.0%) of them were in the age range of 40-45. The majority of respondents, 56 (56%), were males. About 33 (33.0%) of all respondents had secondary education, and only 2 (2.0%) respondents had postgraduate degrees. Also, the results showed that the majority of respondents, 28(28%), were government employees, most of the respondents, 47(47.0%), were single in marital status, and the majority of respondents, 83(83%), were Muslim, as described in Table 1.

Distribution of respondents by knowledge of voluntary blood donation

The results in Table 2 showed that the mean knowledge of the response was 46%, a maximum score of 90%, and a minimum score of 0% in descriptive statistics. Most of the respondents, 84 (84%), were aware that diabetic people could not donate blood, 68 (68%) were aware that people under medication could not donate blood, 64 (64%) were aware that people living with HIV/AIDS could not donate blood and 62 (62%) were aware that people with hepatitis could not donate blood. Most respondents showed poor knowledge on questions asked about the maximum age for voluntary blood donation, criteria for someone to donate blood, and the best source for blood donation by 16 (16%), 25 (25%), and 26 (26%), respectively. This study revealed that 48% and 52% of participants holding adequate and inadequate knowledge respectively, as shown in Figure.

Association of predictor variables and level of knowledge among participants

In this research, a significant correlation between predictor variables and the level of knowledge among adult residents in the Mwanakwerekwe ward was analyzed through bivariate analysis. Among the independent variables examined, only two (participants' level of education and occupation) displayed a significant association with the level of knowledge, all with a P-value (P< 0.05). In contrast, the rest of the independent variables showed no significant correlation with the level of knowledge, all with a P-value (P> 0.05), as illustrated in Table 3.

Factors impacting the level of knowledge on blood donation among adult residents

The participants' knowledge level was computed by binary logistic regression with predictor variables. Adequate knowledge as a reference category was contrasted against inadequate knowledge. Binary logistic regression results shown in Table 4 indicate that only one predictor (occupation of participants) significantly predicted a relationship with a P-value < 0.05. Private employee participants significantly increased the odds of inadequate knowledge by a factor of 6.2 (AOR =6.239, 95% CI: 1.378-28.254, P =0.018).

Table 3. Bivariate analysis of the predictor variables and level of knowledge among participants (N=100) 

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Table 4: Binary logistic regression of predictor variables and level of knowledge among participants. 

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