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Screening for a raised rectal temperature in Africa
R J Jones1, T J O'Dempsey, B M Greenwood
1Medical Research Council Laboratories, Fajara, Banjul, The Gambia, West Africa.
Insights
Axillary temperature measurements are a reliable screening tool for detecting fever in African children. A raised axillary temperature accurately predicts a raised rectal temperature, aiding in prompt diagnosis and treatment.
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.
Abstract:
The main purpose of this study was to compare rectal and axillary temperature measurements in African children. Altogether 573 sick children were seen in an outpatient setting in rural West Africa. Rectal and axillary temperatures were measured and the parent or guardian was asked if they thought that the child had a raised body temperature. Normal ranges were defined from an age matched population of 203 healthy children. A raised axillary temperature predicted a raised rectal temperature with a sensitivity of 98% and a specificity of 88%. The parents' impression that their child had a fever was a less sensitive (89%) and less specific (59%) indicator of raised rectal temperature. A raised axillary temperature is a good screening test for a raised rectal temperature in African children.