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Tepid sponging to reduce temperature in febrile children in a tropical climate
A F Mahar1, S J Allen, P Milligan
1Liverpool School of Tropical Medicine, England.
Insights
Tepid sponging combined with antipyretic medication significantly reduces fever in children more effectively than medication alone. This method is particularly beneficial for febrile children in tropical climates.
Area of Science:
- Pediatrics
- Tropical Medicine
- Clinical Research
Background:
- Fever management in children is crucial, especially in tropical environments.
- Antipyretic medications are standard treatment for febrile children.
- The efficacy of adjunctive therapies like tepid sponging requires further investigation.
Purpose of the Study:
- To assess the effectiveness of tepid sponging combined with antipyretic medication for fever reduction in children.
- To compare the efficacy of tepid sponging plus paracetamol versus paracetamol alone in febrile children in a tropical setting.
Main Methods:
- A prospective, randomized, open trial was conducted with 75 febrile children (6-53 months) in Bangkok, Thailand.
- Participants received either tepid sponging with oral paracetamol or paracetamol alone.
- Rectal temperature, crying, irritability, and shivering were monitored for 2 hours.
Main Results:
- The tepid sponging group exhibited a greater and more rapid decrease in mean rectal temperature compared to the control group.
- Significantly more children in the sponged group achieved a temperature below 38.5°C within 2 hours (P < 0.001).
- At 60 minutes, 95% of controls remained febrile (≥38.5°C) versus 42.9% in the sponged group (P < 1 x 10(-5)).
Conclusions:
- Tepid sponging, when used with antipyretic medication, is demonstrably more effective than antipyretic medication alone for reducing fever in children in tropical climates.
- While crying was associated with sponging, significant adverse effects like shivering or irritability were minimal.
- This study supports the integration of tepid sponging as an effective adjunctive fever-reduction strategy in pediatric care within tropical regions.
Abstract:
The effectiveness of tepid sponging, in addition to antipyretic medication, in the reduction of temperature in febrile children living in a tropical environment, was assessed in a prospective, randomized, open trial. Seventy-five children aged between 6 and 53 months who attended the casualty department of the Children's Hospital, Bangkok, Thailand, with fever (rectal temperature > or = 38.5 degrees C) of presumed viral origin were randomized to received either tepid sponging and oral paracetamol (sponged group) or paracetamol alone (control group). Rectal temperature and the occurrence of crying, irritability, and shivering were recorded over the following 2 hours. A greater and more rapid fall in mean rectal temperature occurred in the sponged group than in the control group. Temperature fell below 38.5 degrees C sooner in children in the sponged group than in control children (P < 0.001). At 60 minutes, 38 (95.0%) of the controls still had a temperature of 38.5 degrees C or greater, compared with only 15 children (42.9%) in the sponged group (P < 1 x 10(-5). Crying was associated with sponging, but shivering and irritability occurred in only one child who was being sponged. It is concluded that tepid sponging, in addition to antipyretic medication, is clearly more effective than antipyretic medication alone in reducing temperature in febrile children living in a tropical climate.