Prevalence of Soil-transmitted Helminth Infections Among School-age Children in Ethiopia: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Muluken Azage ◽  
Achenef Motbainor ◽  
Genet Gedamu ◽  
Wendemagegne Enbiale
Keyword(s):  
Systematic Review ◽  
Control Strategies ◽  
Data Extraction ◽  
Meta Analysis ◽  
Control Measures ◽  
School Age Children ◽  
Cochrane Library ◽  
School Age ◽  
Preventive Chemotherapy ◽  
Pooled Prevalence

Abstract Background: In Ethiopia, soil-transmitted helminthiasis (STHs) infections remain the leading cause of morbidity among school-age children despite the progress in the implementation of control measures. Study findings regarding prevalence of STH among school-age children have been inconsistent and pooled prevalence of STH infections did not account double or triple infections of STH. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of STH by accounting double or triple infections among school-age children in Ethiopia.Methods: Databases and search engines such as PubMed, Web of Science, EMBASE, CINAHL, Google Scholar, Science Direct, and the Cochrane Library were systematically searched. Based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was employed to determine the prevalence of STH infections among school-age children. Published articles in the period between 1980 and 2020 were included in the analysis. Three authors independently extracted all data using a data extraction format sheet. STATA Version 16 statistical software was used for analysis. The Cochran’s Q-test was used to evaluate the heterogeneity of the studies and a random-effects model was done to determine pooled prevalence estimate.Results: The overall pooled estimate of STHs was 33% (95% CI:26-39%). The prevalence did not show statistically differ between before, 32.0% (95% CI:25-39%) and after, 33% (95% CI:26-39%) National NTDs control and elimination programme. The pooled prevalence of ascariasis before and after the implementation of NTDs programme was found to be 18% (12.0%, 24%) and 18% (9.0%, 27.0%), respectively with a total pooled estimate of 18.0% (13.0%, 23.0%). The prevalence of trichuris trichuria was also found to be 8.0% (4.0%, 12.0%) before the programme and 15.0% (4%, 26%) after the programme with a total pooled estimate of 10.0% (5.0%, 14.0%). The prevalence of hookworm was 14.0% (9.0%, 19.0%) before the programme and 9.0% (3.0%, 14.0%) after the programme with a total pooled estimate of 12% (8.0%, 17.0%). Conclusion: The overall polled prevalence of STHs in Ethiopia was found at moderate level based on the WHO classification. The recommended control strategies for STHs infections in school-age children at this level of prevalence such as providing preventive chemotherapy or treat all school-age children (enrolled and non-enrolled) once a year, improving sanitation and water supply and providing health education should be strengthen to mee the target of the national and WHO plan.

scholarly journals Prevalence of Schistosoma mansoni infection in Ethiopia: a systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Siraj Hussen ◽  
Demissie Assegu ◽  
Birkneh Tilahun Tadesse ◽  
Techalew Shimelis
Keyword(s):  
Systematic Review ◽  
Schistosoma Mansoni ◽  
Rural Areas ◽  
Control Strategies ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Cochrane Library ◽  
African Countries ◽  
Preventive Chemotherapy ◽  
Pooled Prevalence

Abstract Background Schistosomiasis is a common helminthic infection in the tropics and subtropics, particularly in sub-Saharan African countries including Ethiopia. In these counties, Schistosoma mansoni infection is a significant public health problem due to the risk of reinfection and recurrent disease despite implementing several rounds preventive chemotherapy. This systematic review and meta-analysis aimed at assessing the pooled prevalence of schistosomiasis in Ethiopia. Methods The PRISMA guidelines were followed to perform the systematic review and meta-analysis. Published studies from January 1999 to June 2020 were searched in Medline, PubMed, Google Scholar, EMBASE, HINARI, and Cochrane Library using key words including: “prevalence”, “incidence”, “schistosomiasis” “Bilharziasis”, “Bilharzia”, “S. mansoni “, “Ethiopia”. Heterogeneity of included studies was assessed using Cochran’s Q test and I2 test statistics while publication bias was assessed using Egger’s test. Results Ninety-four studies were included in the systematic review and meta-analysis. The pooled prevalence of S. mansoni in Ethiopia was 18.0% (95%CI: 14.0–23.0). The southern region of Ethiopia had a higher S. mansoni prevalence of 25.9% (995% CI, 14.9–41.1) than the national prevalence. The burden of S. mansoni infection was also higher than the national average in rural areas and among men with pooled prevalence of 20.2% (95% CI, 13.2–28.5) and 28.5% (95%CI, 22.7,35.1), respectively. The trend analysis showed that the prevalence of S. mansoni infection in Ethiopia decreased over the past 15 years, potentially because of the repeated preventive chemotherapy. Conclusion The review unveiled a moderate prevalence of S. mansoni infection in Ethiopia. Targeted treatment of at-risk population groups ad high burden areas coupled with implementation of integrated vector control strategies are critical to address the burden of Schistosomiasis.

scholarly journals Impact of child summertime obesity interventions on body mass index, and weight-related behaviours: a systematic review and meta-analysis protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017144 ◽  
Author(s):  
Jennette P Moreno ◽  
Lydi-Anne Vézina-Im ◽  
Elizabeth M Vaughan ◽  
Tom Baranowski
Keyword(s):  
Systematic Review ◽  
Body Mass Index ◽  
Sedentary Behaviour ◽  
Body Mass ◽  
Meta Analysis ◽  
Overweight And Obesity ◽  
Risk Of Bias ◽  
School Age Children ◽  
Cochrane Library ◽  
School Age

IntroductionIn previous studies, it has been found that on average, children consistently gained weight during the summer months at an increased rate compared with the 9-month school year. This contributed to an increased prevalence of overweight and obesity in children. Several obesity-related interventions have occurred during or targeting the summer months. We propose to conduct a systematic review and meta-analysis of the impact of obesity prevention and treatment interventions for school-age children conducted during the summer or targeting the summer months when children are not in school on their body mass index (BMI), or weight-related behaviours.Methods and analysesA literature search will be conducted by the first author (JPM) using MEDLINE/PubMed, Cochrane Library, Scopus, CINAHL, PsycINFO, EMBASE and Proquest Dissertations and Theses databases from the date of inception to present. Studies must examine interventions that address the modification or promotion of weight-related behaviours (eg, dietary patterns, eating behaviours, physical activity (PA), sedentary behaviour or sleep) and target school-age children (ages 5–18). The primary outcomes will be changes from baseline to postintervention and/or the last available follow-up measurement in weight, BMI, BMI percentile, standardised BMI or per cent body fat. Secondary outcomes will include changes in dietary intake, PA, sedentary behaviour or sleep. Risk of bias will be assessed using the Cochrane risk of bias tool for randomised and non-randomised studies, as appropriate.Ethics and disseminationBecause this is a protocol for a systematic review, ethics approval will not be required. The findings will be disseminated via presentations at scientific conferences and published in a peer-reviewed journal. All amendments to the protocol will be documented and dated and reported in the PROSPERO trial registry.PROSPERO registration numberCRD42016041750

Estimating neoplasia detection rate (NDR) in patients with Barrett’s oesophagus based on index endoscopy: a systematic review and meta-analysis

Gut ◽  
2019 ◽  
Vol 68 (12) ◽  
pp. 2122-2128 ◽  
Author(s):  
Sravanthi Parasa ◽  
Madhav Desai ◽  
Anusha Vittal ◽  
Viveksandeep T Chandrasekar ◽  
Asad Pervez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Detection Rate ◽  
Data Extraction ◽  
Meta Analysis ◽  
Quality Measure ◽  
Barrett’S Oesophagus ◽  
Oesophageal Adenocarcinoma ◽  
Cochrane Library ◽  
Barrett's Oesophagus ◽  
Pooled Prevalence

BackgroundBiopsies are obtained to confirm intestinal metaplasia and rule out prevalent dysplasia and cancer when Barrett’s oesophagus (BE) is detected at index upper endoscopy (oesophagogastroduodenoscopy [EGD]).AimThe purpose of this systematic review was to obtain summary estimates of the prevalence of high-grade dysplasia (HGD) and oesophageal adenocarcinoma (EAC) associated with BE during index EGD for chronic GERD symptoms, defined as neoplasia detection rate (NDR) which could be used as a quality measure.MethodsAn extensive search was performed within PUBMED, EMBASE and the Cochrane Library databases to identify studies in which patients underwent index endoscopy for the evaluation of the presence of BE. Two reviewers independently evaluated both the study eligibility and methodological quality and data extraction. A random-effects model (REM) based on the binomial distribution was used to calculate the pooled effects of the prevalence of BE-associated dysplasia and EAC.ResultsFor the calculation of dysplasia and EAC prevalence rates, a total of 11 studies with 10 632 patients met the inclusion criteria including 80.4% men with a mean age of 58.7 years and average BE length of 3.5 cm. The pooled prevalence of EAC, HGD and LGD was 3%(95% CI 2 to 5, 9 studies: 396/10 539 patients), 3%(95% CI 2 to 5 [REM], 9 studies: 388/10 539 patients) and 10%(95% CI 7 to 15 [REM], 10 studies: 907/8945 patients), respectively. For NDR, that is, the pooled prevalence of HGD/EAC was 7%(95% CI 4 to 10 [REM], 10 studies: 795/10 632 patients).ConclusionNDR is approximately 4% and could be used as a quality measure.

scholarly journals Epidemiology of intestinal parasitic infections in Ethiopian children: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Legese Chelkeba ◽  
Zeleke Mekonnen ◽  
Yonas Alemu ◽  
Daniel Emana
Keyword(s):  
Systematic Review ◽  
Geographical Distribution ◽  
Intestinal Parasites ◽  
Meta Analysis ◽  
School Age Children ◽  
Parasitic Infections ◽  
School Age ◽  
Pooled Prevalence ◽  
Parasite Infections ◽  
Risk Areas

Abstract Background : Numerous studies have been carried out on assessing the prevalence of intestinal parasites infections (IPIs) among preschool and school-age children in Ethiopia, but there is lack of study systematically gathered and analyzedinformation for policymakers. Therefore, the aim of this systematic review and meta-analysis was to provide a summary on prevalence, geographical distribution and trends of IPIs among preschool and school-age childrenin Ethiopia. Methods :The search were carried out in Medline via PubMed, Scopus, Science Direct, Web of Science, and Google Scholar from 1996to July2019 for studies describing prevalence of IPIs among preschooland school-age children. We conducted meta-regression to understand the trends and the source of heterogeneity and pooled the prevalence using ‘metaprop’ command using STATA software version 14. Results : Eighty-three(83) studies examining 56,786 fecal specimens were included. The prevalence of IPIs was 48 %( 95%CI: 42% to 53%) and showedsignificantly decreasing trends 17% (95% CI: 2.5% to 32%) for each consecutive 6 years) and was similar in males and females. The pooled prevalence in years 1997–2002, 2003–2008, 2009–2014 and >2014 was 71% (95% CI: 57% to 86%), 42% (95% CI: 27% to 56%), 48% (95% CI: 40% to 56%) and 42% (95% CI: 34% to 49%), respectively. Poly-parasitism was observed in 16% (95% CI: 13% to 19 %,) of the cases. Conclusion: Intestinal parasite infections are highly prevalent among preschool and school-age children and well distributed across the regional states of Ethiopia. Southern and Amhara regional states carry the highest burden.We observed significant decreasing trends in prevalence of IPIs among preschool and school-age Ethiopian children over the last two decades.Therefore, this study is important to locate the geographical distribution and identified high risk areas that should be prioritized further interventions, which complement global efforts towards elimination of IPIs infections by 2020

scholarly journals Prevalence of Goiter Among School-Aged Children in Ethiopia: Update of Systematic Review and Meta-analysis

2021 ◽  
Vol 10 ◽  
pp. 216495612098866
Author(s):  
Yohannes Tekalegn ◽  
Kebebe Bekele ◽  
Biniyam Sahiledengle ◽  
Demelash Woldeyohannes
Keyword(s):  
Systematic Review ◽  
Iodine Deficiency ◽  
Meta Analysis ◽  
Random Effect ◽  
Health Concern ◽  
School Age Children ◽  
Forest Plot ◽  
School Age ◽  
Analysis Model ◽  
Pooled Prevalence

Background Iodine deficiency is a major public health concern throughout the world. Goiter is the most visible sign of iodine deficiency. In Ethiopia, a study finding regarding the prevalence of goiter among school-age children is inconsistent and highly variable. Objectives To estimate the pooled prevalence of goiter among school-age children in Ethiopia. Methods Three international databases (MEDLINE/Pub-Med, Google Scholar and Science Direct) were systematically searched. Besides, the reference sections of identified articles were searched to increase the chance of detecting missed articles in gray literature. STATA Version 14 statistical software was used to conduct a meta-analysis. The pooled prevalence with a 95% confidence interval was displayed using the forest plot. A random-effect meta-analysis model was used to compute the pooled prevalence, and The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Results A total of 14 studies fulfilled the inclusion criteria and included in this systematic review and Meta-analysis, with a total sample size of 26,282. The finding of this systematic review revealed that the pooled prevalence of goiter among school-age children was 42.9% (95% CI: 38.8–46.9). The highest prevalence of goiter (46.7%) was observed in Oromia region and the lowest (26.3%) was observed in Benishangul-Gumuz region. Conclusions This review finding revealed that more than two in five of the school children in Ethiopia suffer from iodine deficiency disorder as manifested by the goiter rate.

scholarly journals The Prevalence of Depression among Diabetic Patients in Ethiopia: A Systematic Review and Meta-Analysis, 2018

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Henok Mulugeta Teshome ◽  
Getenet Dessie Ayalew ◽  
Fasil Wagnew Shiferaw ◽  
Cheru Tesema Leshargie ◽  
Dube Jara Boneya
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Addis Ababa ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Comorbid Depression ◽  
Pooled Prevalence ◽  
Prevalence Of Depression

Background. Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. Depression is one of the major important public health problems that is often comorbid with diabetes. Despite the huge effect of comorbid depression and diabetes, the overall pooled prevalence of depression among diabetic patients in the country level remains unknown. Therefore, the objective of this systematic review and meta-analysis is to estimate the pooled prevalence of depression among patients with diabetes mellitus in Ethiopia.Method. Data extraction was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were accessed through electronic web-based search from PubMed, Cochrane Library, Google Scholar, Embase, and PsycINFO. All statistical analyses were done using STATA version 11 software using random effects model. The pooled prevalence was presented in forest plots.Results. A total of 9 studies with 2944 participants were included in this meta-analysis and the overall pooled estimated prevalence of depression among diabetic patients in Ethiopia was 39.73% (95% CI (28.02%, 51.45%)). According to subgroup analysis the estimated prevalence of depression in Addis Ababa was 52.9% (95% CI: 36.93%, 68.88%) and in Oromia region was 45.49% (95% CI: 41.94, 49.03%).Conclusion. The analysis revealed that the overall prevalence of comorbid depression among diabetic patients in Ethiopia was high. Therefore, Ministry of Health should design multisectorial approach and context specific interventions that address this comorbid depression in this specific group as well as general population.

scholarly journals Unmet need for family planning in Ethiopia and its association with occupational status of women and discussion to her partner: a systematic review and meta-analysis

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Solomon Adanew Worku ◽  
Yohannes Moges Mittiku ◽  
Abate Dargie Wubetu
Keyword(s):  
Systematic Review ◽  
Family Planning ◽  
Data Extraction ◽  
Meta Analysis ◽  
Occupational Status ◽  
Unmet Need ◽  
Systemic Review ◽  
Cochrane Library ◽  
Pooled Prevalence ◽  
Status Of Women

Abstract Background Unmet need refers to fecund women who either wish to postpone the next birth (spacers) or who wish to stop childbearing (limiters) but are not using a contraceptive method. Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for family planning. Therefore, the objective of this systematic review and meta-analysis is to estimate the pooled prevalence of unmet need for family planning and its association to occupational status of women and discussion to her partner among fecund women in Ethiopia. Method A systemic review and meta-analysis was conducted using published and unpublished research on the prevalence of unmet need for family planning and its association to occupational status of women and discussion to her partner among fecund women in Ethiopia. Data extraction was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were accessed through electronic web-based search from PubMed, Cochrane Library, Google Scholar, CINAHL, and Embase. All statistical analysis were done using STATA version 14 software using random effects model. The pooled prevalence was presented in forest plots. Results A total of 9 studies with 9785 participants were included, and the overall pooled estimated prevalence of unmet need for family planning among fecund women in Ethiopia was 34.90% (95% CI: 24.52, 45.28%). According to subgroup analysis the estimated prevalence of unmet need for family planning in studies conducted in Amhara was 32.98% (95% CI: 21.70, 44.26%), and among married women was 32.84% (95% CI: 16.62, 49.07%). Additionally, housewife women were 1.6 times more likely have unmet need for family planning compared to government employed women (OR: 1.6, 95% CI: 1.29, 1.99). Moreover, women who don’t discuss to partner were 1.87 times more likely to have unmet need for family planning compared to women who had discussion to her partner (OR 1.87; 95% CI: 1.52, 2.31). Conclusion The analysis revealed that the overall prevalence of unmet need for family planning among fecund women in Ethiopia was high. Family planning programs should identify strategies to improve communication in family planning among couples and to ensure better cooperation between partners.

scholarly journals Prevalence of retinopathy in prediabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Data Extraction ◽  
Meta Analysis ◽  
International Diabetes Federation ◽  
Current Data ◽  
Risk Of Bias ◽  
Fundus Photography ◽  
Primary Data ◽  
Cochrane Library

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.

scholarly journals Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (8) ◽  
pp. 3991
Author(s):  
Antonio Jose Martin-Perez ◽  
María Fernández-González ◽  
Paula Postigo-Martin ◽  
Marc Sampedro Pilegaard ◽  
Carolina Fernández-Lao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastasis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Vertebral Metastasis ◽  
Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

Executive functions in children with heart disease: a systematic review and meta-analysis

2021 ◽  
pp. 1-9
Author(s):  
William M. Jackson ◽  
Nicholas Davis ◽  
Johanna Calderon ◽  
Jennifer J. Lee ◽  
Nicole Feirsen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Executive Functions ◽  
Data Extraction ◽  
Meta Analysis ◽  
Executive Dysfunction ◽  
Cochrane Library ◽  
Planning Problem ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Increased Risk

Abstract Context: People with CHD are at increased risk for executive functioning deficits. Meta-analyses of these measures in CHD patients compared to healthy controls have not been reported. Objective: To examine differences in executive functions in individuals with CHD compared to healthy controls. Data sources: We performed a systematic review of publications from 1 January, 1986 to 15 June, 2020 indexed in PubMed, CINAHL, EMBASE, PsycInfo, Web of Science, and the Cochrane Library. Study selection: Inclusion criteria were (1) studies containing at least one executive function measure; (2) participants were over the age of three. Data extraction: Data extraction and quality assessment were performed independently by two authors. We used a shifting unit-of-analysis approach and pooled data using a random effects model. Results: The search yielded 61,217 results. Twenty-eight studies met criteria. A total of 7789 people with CHD were compared with 8187 healthy controls. We found the following standardised mean differences: −0.628 (−0.726, −0.531) for cognitive flexibility and set shifting, −0.469 (−0.606, −0.333) for inhibition, −0.369 (−0.466, −0.273) for working memory, −0.334 (−0.546, −0.121) for planning/problem solving, −0.361 (−0.576, −0.147) for summary measures, and −0.444 (−0.614, −0.274) for reporter-based measures (p < 0.001). Limitations: Our analysis consisted of cross-sectional and observational studies. We could not quantify the effect of collinearity. Conclusions: Individuals with CHD appear to have at least moderate deficits in executive functions. Given the growing population of people with CHD, more attention should be devoted to identifying executive dysfunction in this vulnerable group.

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