This scoping review reveals significant knowledge gaps and critical challenges in addressing neglected tropical diseases (NTDs) in Somalia, a country severely affected by poverty, fragile healthcare systems, and prolonged political instability (13, 45). The 36 studies included in this review highlight the disproportionate focus on a subset of NTDs, namely visceral leishmaniasis and schistosomiasis, while other diseases such as soil-transmitted helminthiases, chikungunya, rabies, and mycetoma remain underexplored. This disparity underscores the fragmented nature of research efforts and the urgent need for a more comprehensive approach to NTD research in Somalia. Our findings are consistent with prior review conducted in sub-Saharan Africa, suggesting that the overall burden of neglected tropical diseases (NTDs) in Africa may be significantly underestimated (4).

The predominance of studies on visceral leishmaniasis and schistosomiasis reflects the historically recognized burden of these diseases in the country. For example, visceral leishmaniasis studies dating back to the 1960s have documented endemic regions and highlighted critical gaps in treatment access, particularly in rural areas. Recent studies, however, remain scarce and often focus on case reports, leaving significant gaps in epidemiological data and diagnostic capacity. Similarly, despite the high prevalence of schistosomiasis reported in earlier studies, updated prevalence data is limited, and no recent large-scale control initiatives have been documented. The decline in recent research suggests a stagnation in efforts to understand and mitigate these diseases. A striking finding is the paucity of research on other WHO-recognized NTDs, despite their known presence in Somalia and neighboring countries. For instance, leprosy is a WHO priority in Somalia, yet only two studies addressed this disease, and no studies employed social science or program evaluation methods to understand barriers to diagnosis, treatment, or stigma. Likewise, diseases like rabies, soil-transmitted helminthiases, and chikungunya, which are prevalent in resource-limited settings (3, 46), remain underrepresented in Somali research. This lack of diversity in research focus hampers efforts to design effective interventions for the full spectrum of NTDs affecting the country.

The review also underscores systemic challenges in local research capacity and infrastructure. With 52.8% of studies led by non-Somali researchers, there is a clear need to strengthen the role of Somali researchers in NTD research. Limited local leadership not only impacts the relevance and sustainability of research but also hinders the translation of findings into actionable policy (47). Enhancing local capacity through training, infrastructure development, and partnerships with international organizations is imperative for sustainable progress. Moreover The minimal involvement and/or recognition of local researchers as authors likely mirrors wider patterns in academic publishing, where researchers from Africa are often underrepresented (48).

Methodological limitations further constrain the utility of existing studies. Over half of the included studies were descriptive, with few employing robust epidemiological or experimental designs. Notably, there was no use of social science or economic approaches, which are essential for understanding the broader social determinants of NTDs and the economic impact of interventions. The lack of methodological diversity and transparency, such as unspecified laboratory techniques in some studies, weakens the evidence base needed to inform policy and program development. Additionally, It is well-documented that data challenges related to NTDs remain a global issue (49, 50). Policy-oriented research was another critical gap identified. While neighboring countries like Kenya (16) and Ethiopia (17) have implemented master plans for NTD prioritization, Somalia lacks a comprehensive strategy for NTD control and surveillance. Only 11.1% of studies in this review focused on policy, and there were no comprehensive evaluations of existing health system capacities or community-based interventions. Given Somalia’s unique sociopolitical and environmental challenges, developing a context-specific NTD master plan should be a priority.

The findings of this review have several implications for future research and policy. First, there is a pressing need to prioritize systematic epidemiological studies to map the current prevalence, risk factors, and geographic distribution of NTDs in Somalia. Integrating these studies with capacity-building initiatives, such as training Somali researchers and establishing local laboratories, will help address critical infrastructure gaps. Second, expanding research to underexplored NTDs and employing diverse methodologies, including social science and economic evaluations, will provide a more comprehensive understanding of the disease burden and the effectiveness of interventions. Third, fostering collaborations between Somali researchers, government bodies, and international partners is essential to establish a coordinated approach to NTD research and policy development.

Finally, this review highlights the importance of embedding NTD research within Somalia’s broader health and development agenda. Addressing NTDs requires not only biomedical solutions but also interventions targeting the social determinants of health, such as poverty, sanitation, and education. Community-based approaches and participatory research methods can empower local communities and ensure that interventions are culturally appropriate and sustainable.