Can Mother’s Touch Really Assess Fever in Children - A Prospective Cross-Sectional Study Conducted in Paediatric Department, MGM Hospital, Warangal

BACKGROUND Fever is one of the most common complaints encountered by paediatric practitioners in the clinics and hospitals. Fever as a complaint alone, accounts for 25% of the complaints among others like cold, cough, vomiting etc. Most often it is the first noticed sign by the parents especially, mothers. Very often parents don’t consider fever as a sign of illness, but fever itself is considered as an illness. Most of the mothers presume fever by tactile perception and seek medical consultation. Fever is a complex physiologic response to disease mediated pyrogenic cytokines and characterized by a rise in core temperature. In this study, we want to determine if assessment of fever by touch of the mother correlates with measured temperature simultaneously. METHODS This study was done in department of Paediatrics, MGM Hospital, Warangal in the age group 6months and 12 years between October 2019 to April 2020. Axillary temperature was measured simultaneously in all those children where mother perceived fever by touch, admitted to the paediatric department MGMH hospital. Temperature more than 99.4 F measured in the axillary area was considered as fever. RESULTS Of the 199 mothers 74 i.e., (37.19 %) perceived fever correctly and 125 i.e., (62.81 %) perceived fever which was not recorded on measurement. when educational status of the mother was considered ,graduate mothers could perceive fever better when compared to illiterate mothers. CONCLUSIONS In the present study we found that fever perception by tactile sensation is inferior to measured temperature. Parents often wrongly perceive normal temperature as fever and rush to seek professional care. Even educated mothers were unable to assess fever correctly by touch. The results of this study may thus be potentially useful in reassuring parents with fever phobia. All mothers should be motivated and encouraged for use of standardized thermometer to measure fever even at home , thus reducing the burden of false fever in our OPD`S and hospitals. KEYWORDS Mothers, Perceived Fever, Measured Temperature

Fever of Unknown Origin

Key Points Children with fever of unknown origin generally do well, even if the fever persists beyond 2 weeks.Among children, most cases of fever of unknown origin are caused by infections that are usually self-limited or treatable.Thorough history and examination are the most important tools of evaluation.Given how common “fever phobia” is, careful explanation and reassurance are key to management.

Understanding Discomfort in Order to Appropriately Treat Fever

Although national and international guidelines on the management of childhood and adolescent fever are available, some inadequate practices persist, both from parents and healthcare professionals. The main goal of bringing children’s temperature back to normal can lead to the choice of inappropriate drugs or non-necessary combination/alternation of antipyretic treatments. This behavior has been described in the last 35 years with the concept of fever-phobia, caused also by the dissemination of unscientific information and social media. It is therefore increasingly important that pediatricians continue to provide adequate information to parents in order to assess the onset of signs of a possible condition of the child’s discomfort rather than focusing only on temperature. In fact, there is no clear and unambiguous definition of discomfort in literature. Clarifying the extent of the feverish child’s discomfort and the tools that could be used to evaluate it would therefore help recommend that antipyretic treatment is appropriate only if fever is associated with discomfort.