Screening for a raised rectal temperature in Africa

Area of Science:

• Pediatric Medicine
• Tropical Health
• Clinical Thermometry

Background:

• Accurate body temperature measurement is crucial for diagnosing febrile illnesses in children, particularly in resource-limited settings.
• Traditional rectal temperature measurement can be invasive and challenging in pediatric populations.
• Axillary temperature measurement offers a less invasive alternative, but its accuracy in identifying true fever requires validation.

Purpose of the Study:

• To compare the accuracy of rectal and axillary temperature measurements in identifying fever in African children.
• To evaluate the effectiveness of axillary temperature as a screening tool for elevated body temperature in this population.
• To assess the reliability of parental perception of fever compared to objective temperature measurements.

Main Methods:

• A comparative study involving 573 sick children in a rural West African outpatient setting.
• Simultaneous measurement of rectal and axillary temperatures.
• Comparison with a reference range established from 203 healthy, age-matched children.
• Assessment of parental reports of perceived fever.

Main Results:

• A raised axillary temperature demonstrated high sensitivity (98%) and good specificity (88%) in predicting a raised rectal temperature.
• Parental assessment of fever was less accurate, with lower sensitivity (89%) and specificity (59%) compared to rectal measurements.
• Axillary thermometry proved to be a valuable screening method for detecting fever in the study population.

Conclusions:

• Axillary temperature measurement is a sensitive and specific indicator for screening elevated body temperature in African children.
• This non-invasive method can effectively identify children requiring further clinical evaluation for fever.
• Axillary thermometry is a practical and reliable tool for fever screening in pediatric healthcare settings in resource-limited regions.