Tropical kidney diseases: underrepresented in foundational English-language medical education resources

Abstract

Tropical nephrology refers to kidney diseases commonly found in tropical and subtropical regions. These conditions, such as malaria-associated acute kidney injury, leptospirosis with renal involvement, schistosomiasis-related nephropathy, HIV-associated nephropathy, and dengue-associated kidney injury, are becoming increasingly relevant to clinicians worldwide due to global travel, climate change, and migration. However, their coverage in foundational English-language medical education resources may be inadequate, potentially impairing clinicians’ ability to manage these conditions effectively. To assess the extent of this gap, a structured content review was conducted across 12 widely used English-language educational materials, including general internal medicine and nephrology textbooks, tropical medicine references, and digital platforms like UpToDate. Each resource was evaluated for its coverage of five conditions across six educational domains (epidemiology, pathophysiology, clinical presentation, diagnosis, management, and prevention) using a modified DISCERN tool with a 5-point scale. The review found that overall coverage was limited, with a mean DISCERN score of 2.2 out of 5. Tropical medicine textbooks (mean 3.2) and digital platforms (mean 2.8) scored higher than general internal medicine texts (mean 1.7). Diagnosis and prevention were the least covered domains, while HIV-associated nephropathy received the most attention. These findings highlight significant gaps in core English-language educational materials that may contribute to challenges in how clinician manage these diseases. There is a clear need for improved and updated medical curricula to support better recognition, diagnosis, and treatment of tropical kidney diseases in an increasingly interconnected world.