Accuracy of mother's touch in assessing the presence of fever in children

Abstract

Background: Fever is a very common presenting complaint in children and is of great diagnostic importance. The presence of fever in a child which is often determined by tactile assessment is a major source of concern to caregivers necessitating either the use of medications and /or hospital visitation. Objective: To test the reliability of tactile assessment of fever by mothers and to ascertain if palpation of a single site or multiple sites affects the accuracy. Method: The study was conducted at the University of Benin Teaching Hospital, Benin City between July and September 2009 and involved 359 children aged six months to five years. Each child had a tactile assessment of fever by the mother after which the patient's axillary temperature was measured and documented. Results: One hundred and forty-five mothers (40.4%) palpated multiple sites while 214 mothers (59.6%) palpated a single site. Of those that palpated a single site, the head was the most frequently used site (31%) while the groin was the least used site (0.5%). The sensitivity, specificity, positive predictive value and negative predictive value of mother's perception of fever using a single site were 89.2%, 64.3%, 56.9% and 91.8% respectively while for mothers who used multiple sites were 89.4%, 55.7%, 62.8% and 86.3% respectively. No significant difference was found when the values were compared. Conclusion: Tactile assessment is still a relevant tool in the determination of the presence of fever in children. The use of one or more anatomical sites does not affect its accuracy.

Key Words: Touch, Fever, Accuracy, Children