Knowledge, Attitude, and Perceptions of Uterine Artery Embolization for Uterine Fibroids at Muhimbili National Hospital

Abstract

Background: Uterine Artery Embolization (UAE) is a minimally invasive and effective treatment for symptomatic uterine fibroids. However, its utilization in low-resource settings such as Tanzania remains limited, potentially due to gaps in knowledge, attitudes, and perceptions among patients and healthcare workers (HCWs). This study aimed to assess and compare knowledge, attitudes, and perceptions regarding UAE among HCWs and women diagnosed with uterine fibroids attending Muhimbili National Hospital (MNH), Tanzania.
Methods: A hospital-based prospective cross-sectional study was conducted between December 2023 and June 2024 among 221 participants, including 94 HCWs and 127 women diagnosed with uterine fibroids, attending the Radiology and Obstetrics/Gynaecology departments at MNH. Data were collected using a structured, pre-tested questionnaire administered through interviews and self-completed questionnaires. Information on socio-demographic characteristics, knowledge of UAE, attitudes toward the procedure, and perceptions of its effectiveness was collected. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 26. Descriptive statistics and Pearson’s Chi-square tests were employed to assess associations between variables, with statistical significance set at p<.05.
Results: The mean age of participants was 33.99 ± 7.99 years. All participants (100%) reported awareness of UAE, primarily through healthcare providers (53%) and the internet (43%). Overall knowledge of UAE was suboptimal, particularly among patients with uterine fibroids. Less than half of the participants identified UAE as a minimally invasive procedure (47.3%), while 52.6% recognized that it is performed by interventional radiologists, and 57.5% correctly identified its mechanism of action. Knowledge of indications for UAE was limited, whereas knowledge of contraindications was relatively higher, with pregnancy (70.9%), contrast media allergy (67.6%), and uncorrectable coagulopathy (66.0%) being correctly identified. Knowledge of complications was low (<50%). HCWs demonstrated significantly higher knowledge across all domains compared to patients with uterine fibroids (p<.05). Positive attitudes and perceptions toward UAE were also limited; only 42.1% considered UAE a safe procedure, 38.6% regarded it as an alternative to myomectomy, and 42% recognised its shorter recovery time. Despite this, 66.5% of participants indicated willingness to recommend UAE.
Conclusion: While awareness of UAE was high, detailed knowledge of the procedure, particularly among women with uterine fibroids, remained limited. HCWs demonstrated significantly better knowledge than patients, although important knowledge gaps persisted. Strengthening patient education and enhancing HCWs’ training. Improving communication regarding UAE may enhance its acceptance and utilization in Tanzania.