Ability of mothers to assess the presence of fever in their children: Implication for the treatment of fever under the IMCI guidelines

Background: Fever is a common reason for seeking medical attention, with febrile illnesses accounting for 10% to 20% of pediatric visits to emergency departments. A history of fever or presence of fever by palpation or measured temperature is required on the Integrated Management of Childhood Illnesses (IMCI) algorithms as a reason for the assessment of fever, which will lead to specific classifications that are linked to treatment protocols. Therefore, the WHO and its partners assume that mothers are able to assess their children for the presence of fever. Objectives: To evaluate the ability of mothers to determine the presence of fever in their children by tactile examination of their children. Methods: We prospectively studied 126 mother-child pairs attending the pediatric outpatient clinic of Ahmadu Bello University Teaching Hospital (ABUTH). Mothers of children 2 months to 5 years of age who mentioned fever as part of the presenting complaints were studied using a structured questionnaire regarding their children's illness, temperature status and their educational level. Results: A total of 126 mother-child pairs were studied, of which 44 (34.9%) of the mothers had had their education extended to secondary school level and only 15 (11.9%) had their education extended to a tertiary level. Fever was present in 82 (65.1%) of the children when their temperatures were determined by thermometer. The mothers correctly identified 79 (sensitivity of 96.3%) of the children who were truly febrile and 19 (specifi city of 43.2%) of those who were truly nonfebrile. The predictive value of a positive test was 76.0%, and the predictive value of a negative test was 86.4%. Conclusion: The results showed that mothers in our environment, as has been observed in other parts of the world, are able to correctly assess the presence or absence of fever in their children.