Evidence map›Paper›PMID 42268871›Full record

ArticlePloS one2026

Geospatial variation and machine learning approaches to predict open defecation practice in Zambia.

Andualem Addisu Birlie, Nega Abebe Meshesha, Sefefe Birhanu Tizie, Smegnew Gichew Wondie, Selamawit Gashaw Teshome, Tesfaye Deribe Bedada, Ayana Alebachew Muluneh, Biruktawit Lelisa Eticha, Geleta Nenko Dube, Gelgelo Wodessa and 1 more

Abstract read
In one paragraph

Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Andualem Addisu BirlieDepartment of Health Informatics, College of Medicine and Health Science, Samara University, Samara, Ethiopia.ORCID https://orcid.org/0009-0000-2337-0192
Nega Abebe MesheshaDepartment of Public Health, Institute of Health, Dambi Dollo University, Dambi Dollo, Ethiopia.
Sefefe Birhanu TizieDepartment of Health Informatics, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.
Smegnew Gichew WondieDepartment of Public Health, College of Medicine and Health Science, Mizan Tepi University, Mizan Aman, Ethiopia.
Selamawit Gashaw TeshomeSchool of Public Health, Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
Tesfaye Deribe BedadaDepartment of Health Informatics, School of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia.ORCID https://orcid.org/0009-0003-7102-5790
Ayana Alebachew MulunehDepartment of Health Informatics, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
Biruktawit Lelisa EtichaDepartment of Health Informatics, School of Public Health, College of Medicine and Health Science, Wachemo University, Hossana, Ethiopia.
Geleta Nenko DubeSchool of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia.
Gelgelo WodessaSchool of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia.
Muluken Belachew MengistieDepartment of Health Informatics, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia.ORCID https://orcid.org/0000-0002-0606-9477

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpen defecation is the disposal of human feces in fields, bushes, forests, open waterways, beaches, and other open areas. It worsens the environment, contaminates drinking water sources, causes malnutrition and low school attendance in children, and aids in the spread of diseases like cholera, diarrhea, dysentery, typhoid, polio, and hepatitis A. The purpose of this study was geospatial variation and machine learning approaches to predict open defecation in Zambia.

methodsThis study used secondary data analysis from the cross-sectional Zambia Demographic and Health Survey (ZMDHS) 2024. Spatial distribution, spatial autocorrelation, incremental autocorrelation, spatial interpolation, and hot spot area detection were all examined using ArcGIS 10.7. Python was used to identify the features of open defecation practice using machine-learning algorithms. We carried out an 80/20% data split, one-hot data encoding, data transformation and integration, data cleaning, and 10-fold stratified cross-validation. This study employed seven machine-learning algorithms, including adaptive boosting, cat boosting, random forest, light boosting, extreme gradient boosting, decision tree and logistic regression.

resultsAmong 12,808 households in Zambia, 12.1% were practiced open defecation. Spatial analysis revealed significant clustering, with hot spots concentrated in Southern, Western and Eastern regions, highlighting areas in urgent need of intervention. Machine learning models were applied to predict open defecation practices, with light gradient boost performing the best model with AUC of 83.83%. From this study, 198 true positives were generated by the model for the classification of open defecation practice, accurately identifying those who reported engaging in this behavior.

conclusionWealth index, access to treated water, access to electricity, educational level, and age of household head, access to media, and region were the most significant features of open defecation practice. Governments, NGOs, policy makers, and researchers can use these data to create targeted interventions for improving health and environmental sanitation based on the gaps and disparities discovered.

Indexed as

DefecationMachine LearningBoosting Machine Learning AlgorithmsClassification AlgorithmsCross-Sectional StudiesHumansPrediction AlgorithmsPredictive Learning ModelsRandom ForestSpatial AnalysisZambia

Identifiers

PMID42268871
PMCPMC13252813

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.