Advancing the 2030 NTDs roadmap targets: A scoping review of environmental DNA/RNA applications in neglected tropical diseases

OBJECTIVE: This scoping review aims to evaluate the application of environmental DNA/RNA (eNA) technology in real-world studies on neglected tropical diseases (NTDs), assessing its methodology and detection effectiveness, and providing an evidence-based roadmap for optimizing eNA used to support progress toward the 2030 targets. BACKGROUND: As the NTDs roadmap reaches its midpoint, eNA technology has seen increasing adoption. This non-invasive approach enables qualitative/quantitative assessment of environmental transmission risks, complementing conventional detection methods. METHODS: We synthesized real-world field applications of eNA technology across NTDs through systematic searches in four English, and one Chinese database (2002-2024). A total of 71 studies met our inclusion criteria after screening. RESULTS: Despite heterogeneous transmission mechanisms among NTDs, we identified 6 standardized field applications for eNA studies, along with practical optimization strategies. A total of 3 pathways were concluded of how eNA technology can accelerate the NTDs elimination. For the performance, comparative analyses showed moderate concordance with conventional methods, while eNA demonstrated superior sensitivity in detection of pathogens and hosts. With the gap analysis, we demonstrated the advances of eNA applications in all NTDs. CONCLUSIONS: This scoping review supports eNA technology as a promising tool for NTDs detection and surveillance. Through experience sharing and summarization, the eNA technology needs further optimization and standardization to enhance its disease surveillance capacity, thereby accelerating the achievement of NTDs roadmap targets.