Fever In Children Research Articles

Ateş şikayeti ile acile başvuran ailelerin ateşli çocuğa yaklaşımı

Amaç: Bu çalışmada çocuğunda ateş şikâyeti ile acil servise başvuran ebeveynlerin ateşli çocuğa yaklaşımının incelenmesi amaçlanmıştır. Yöntem: Çalışma kesitsel ve tanımlayıcı araştırma olarak Mart-Mayıs, 2022 tarihleri arasında Karadeniz’de yer alan bir ilde 451 ebeveyn ile yapılmıştır. Veriler, Tanıtıcı Bilgi Formu, Ebeveyn Ateş Yönetim Ölçeği ve Ateş ile İlgili Bilgi, Tutum ve Davranış Değerlendirme Formu ile toplanmış olup SPSS 22.00 paket programında analiz edilmiştir. Bulgular: Çalışmaya katılan annelerin yaş ortalaması 33.22±6.08, çocuklarının yaş ortalaması ise 2.63±1.72’dir. Annelerin %89.1’inin çocuğunu ateş nedeniyle hastaneye ya da doktora götürüldüğü belirlenmiştir. Annelerin Ebeveyn Ateş Yönetim Ölçeği puan ortalaması 35.20±4.13’dir. Çalışmada ateşin bir hastalık olduğunu düşünen anneler ile düşünmeyen annelerin Ebeveyn Ateş Yönetim Ölçeği puan ortalaması arasında istatistiksel olarak fark olduğu saptanmıştır (p

Viral Infections as the most Frequent Causes of Undifferentiated Fever in Children Living in the Lower Mekong Region: A Systematic Review

Viral Infections as the most Frequent Causes of Undifferentiated Fever in Children Living in the Lower Mekong Region: A Systematic Review

Correlation of Platelet Parameters With the Severity of Thrombocytopenia in Dengue Fever in Children Aged Less Than 18 Years at a Tertiary Care Centre: A Cross-Sectional Study.

Introduction Dengue is a tropical viral disease caused by dengue virus with varied severity ranging from dengue fever to dengue shock syndrome. In dengue infection, there is thrombocytopenia with platelet activation. According to various proposed theories, activation of platelets during thrombocytopenia leads to changes in platelet parameters like mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet index (PI). So,this study was conducted to correlate platelet parameters with the severity of thrombocytopenia in children with dengue fever at a tertiary care hospital. Methods An observational cross-sectional study was conducted on 72 children below 18 years admitted with dengue infection at a tertiary care hospital. All 72 patients were divided into three groups depending on platelet count. Group I included individuals with a platelet count less than 50000/mm3, while group II comprised patients with platelet counts ranging between 50001/mm3 and 100000/mm3, and group III encompassed individuals with platelet counts exceeding 100001/mm3. Platelet parameters like MPV, PDW, PCT, and PI were analyzed on day one and day three of admission. These parameters on day one and day three were correlated with the severity of thrombocytopenia in all three groups. Results PCT values on day one and day three were statistically significant (p<0.05) in all three groups with p-value <0.001 withprofound positive correlation, which means PCT value decreases with increasing severity of thrombocytopenia. PI in group I was statistically significant on day one (p=0.009) but not on day three (p=0.063). PI in group II was statistically significant(p<0.05) on day three (p=0.002), while in group III, PI was significant statistically on day one (p<0.001). MPV in group I, on day one(p=0.006) and in group II, on day three(p= 0.049) were statistically significant(p<0.05).PDW was statistically significant only on day one (p=0.031) in group I, while was not significant in groups II and III. Conclusion MPV, PDW, and PCT increasewith a decrease in platelet count, whereas there isan increase in PI. These platelet indices could be used to predict the severity of thrombocytopenia and severity of the dengue fever. Along with MPV and PDW, PCT could be used to assess the severity of the disease progression.

Acute Rheumatic Fever in Children: The Known and the Unknown Among Saudi Mothers in the Jazan Region.

Background Acute rheumatic fever (ARF) is a significant public health problem that causes morbidity and mortality in low and middle-income countries. Therefore, this study aims to assess mothers' knowledge of acute rheumatic fever and their attitudes in the Jazan region. Methods A cross-sectional study was conducted between the mothers using an online survey. The knowledge level was ranked as poor, fair, and good. In contrast, the attitudes were ranked as positive or negative. Association with sociodemographic variables was assessed, and statistical significance was set atp< 0.05. Results Four hundred thirty-six (436) mothers were included; 39.9% of them were aged 21-30 years, 68.8% were married, 57.3% were non-workers, and 72.2% were university-educated. Most of the mothers had a poor level of knowledge (53%); however, positive attitudes toward the disease were reported in 79.1% of mothers. The poor knowledge levels were related to age, marital status, occupation, and monthly income. Conclusion Despite having positive attitudes toward diagnosing and managing ARF, most of the mothers showed poor knowledge of acute rheumatic fever. This study highlights the situation in the Jazan region, which could be an essential basis for constructing an educational program to raise awareness and knowledge of acute rheumatic fever in the community.

Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children

Clinical Profile and Prescription Patterns in Culture-proven Enteric Fever in Children

Discursive Analysis of Pediatrician's Therapeutic Approach towards Childhood Fever and Its Contextual Differences: An Ethnomethodological Study.

Introduction: Fever stands out as the predominant clinical indicator in infancy. Pediatricians encounter fever routinely in their daily practice, playing a crucial role in their interactions with children and families. Objective: The aim is to examine pediatricians' viewpoints, understanding, and approaches regarding childhood fever in two healthcare settings: pediatric hospitalization (emergency and inpatient ward) and primary care. Methods: A qualitative study was conducted using an ethnomethodological approach. Pediatricians working in the specified pediatric settings participated in in-depth interviews where theoretical clinical cases were presented for analysis. Results: Following the examination of the discourses, the codes were organized into eight categories: Understanding of fever, Significance ascribed to fever, Therapeutic strategies, Engagement with the evidence, Family apprehensions regarding fever, Influence of the COVID-19 Pandemic, Inter- and intra-professional relationships, and Suggestions for change: Conclusions: Pediatricians acknowledge the importance of addressing discomfort in the treatment of fever, but express challenges in implementing these recommendations. Pediatricians in inpatient settings emphasize the need for enhanced parental education from primary care, while those in primary care recognize the potential for improvement. Inpatient pediatricians are open to implementing changes in their daily practices, particularly concerning the administration of antipyretics.

Pharmacy Students’ Over-the-counter Recommendations for Primary Dysmenorrhea and Childhood Fever Cases in an Indonesian University

Background: The quality of pharmacy education is stated in the literature to be one of the factors influencing the quality of self-medication services in pharmacies. However, research describing the ability of pharmacy students to handle self-medication cases is limited.Objectives: This study aims to describe pharmacy students’ recommendations for two vignette cases involving analgesic-antipyretics (i.e., primary dysmenorrhea and childhood fever cases) in an Indonesian university and to identify factors related to the appropriateness of their recommendations.Methods: Apothecary students were asked to provide recommendations and their reasoning for primary dysmenorrhea and childhood fever cases using a structured telephone interview.Results: Of the 86 participants, appropriate recommendations were provided by 86% and 78% for a case of primary dysmenorrhea and for childhood fever respectively. One-quarter of students did not identify referral criteria in the case of childhood fever and thus made inappropriate recommendations. Age and study period were factors significantly related to providing appropriate recommendations, in which students who were younger and completed their study program within 5 to 6 years were significantly able to provide appropriate recommendations compared to students who were older and whose study period exceeded 6 years.Conclusion: A considerable number of apothecary students in an Indonesian university were able to properly manage cases related to analgesic-antipyretic recommendations. Further qualitative research is needed to identify factors underlying the knowledge of Indonesian pharmacy students in identifying major and minor patient presentations.

Discursive analysis of nursing care toward childhood fever and its contextual differences: An ethnomethodological study.

Fever is the most common clinical sign during infancy. Nurses deal with fever in children most directly and it is an integral aspect of their role as pediatric nurses. The objective of this study is to analyze the perceptions, knowledge and attitudes toward childhood fever of nurses in three health contexts: pediatric hospitalization, pediatric emergency and primary care. To respond this objective, a qualitative study with ethnomethodological approach has been carried out. In-depth interviews were conducted and theoretical clinical cases were presented to nurses working in pediatrics in the three settings studied. After the analysis of the discourses, the codes were classified into three categories: static and number-centric knowledge, dependent nursing attitude, and unconscious model nurses. On the one hand, when we analyze and compare the perceptions, attitudes and knowledge of the nurses between the different contexts, we find differences that consist mainly of what the context requires of them. On the other hand, in general and regardless of the context, the nurses interviewed place themselves in a traditional framework when faced with the phenomenon of fever in children.

Survey of knowledge, practice, and associated factors toward home management of childhood fever among parents visiting Gondar health facilities in 2022.

Fever is a typical symptom of many sicknesses, but for children under the age of five, fever can have devastating consequences and represents a source of worry for parents. To the best of our knowledge, no research on home management of fever in children has been conducted in Ethiopia. We aimed to assess knowledge, practices, and associated factors towards home management of childhood fever among parents visiting Gondar Town health facilities in 2022. This multicenter institutional-based cross-sectional study was conducted in Gondar public health facilities from June 1st-June 30th, 2022. Participants were fathers and mothers of children aged 0-5 years. A stratified random sampling technique was used. Data were collected through face-to-face interviews using a pretested structured questionnaire. Approximately, 40.2% (95% CI: 35.5%, 45.2%) of parents had good knowledge and only 12.8% (95% CI: 9.7-15.8) of parents practiced home fever management. Being married [Adjusted odds ratio [(AOR) = 2.1 (1.2, 3.2)], having a primary or higher level of education [AOR = 2.4 (1.17, 4.9)] [AOR = 2.0 (1.02-4.6)], respectively, and number of children [AOR = 1.8 (1.63, 2.03)] were factors associated with parental knowledge. Likewise, being married [AOR = 3.05 (2.27.50-3.83)], receiving counseling from health care providers [AOR = 2.12 (1.53-3.32)], and being male [AOR = 2.03 (1.50-3.00)] were significant predictors of practice. Inadequate levels of knowledge and numerous irrational practices related to home fever management were predominant among parents, which needs to be addressed. Evidence-based health education is essential for parents to enhance their level of knowledge and practice to effectively treat fever at home.

Teeth can Tell a Story About Childhood!

Tooth enamel is the hardest substance in the human body. It begins forming during pregnancy and the way it forms can provide valuable information about early life. The cells that produce enamel are extremely sensitive to disturbances, so when a child experiences some kinds of stress during enamel development (childhood diseases, fever, or low concentration of oxygen in the blood for example), layers of enamel may contain “scars” reflecting the stressful experience. The type of enamel scars can tell dentists a story about what may have happened before the person was born or shortly after birth. Understanding enamel development is important for knowing the difference between normal enamel and abnormal changes, and such knowledge can help dentists to diagnose and treat enamel issues, to keep the teeth healthy.

Analysis on childhood fever health information seeking behaviors in online health community using a mixed-methods approach.

The primary aim of this study is to analyze health information seeking behaviors of users related to child fever within online health communities. The findings will serve as a foundation for the development of targeted interventions and resources for addressing the specific information needs related to child fever. Ultimately, this will enhance parental capabilities in managing fever in children and for improving the quality of communication between healthcare professionals and parents dealing with feverish children. This study employed data crawling to gather Q&A data on childhood fever from online health communities, specifically "haodf.com" between March 15, 2022, and March 15, 2023. A total of 47,781 texts were analyzed using a mixed research approach that combines qualitative text topic analysis with BERTopic algorithm. The health information needs regarding children's fever can be categorized into 6 primary topics and 17 secondary topics. Among them, parents' demand for medication consultation and medical guidance (Topic A) was the highest at 45.40%, followed by information concerning the management of fever symptoms and body temperature in children (Topic B) at 30.35%. 13.24% of the data focused on examination recommendations and interpretation of results (Topic C). This study proposes a mixed thematic analysis method combining qualitative text thematic analysis and the BERTopic topic model, which reveals parents' information-seeking behaviors about children with fever. It emphasizes the challenges faced by parents in assessing their children's condition and highlights the necessity of continuous health information support and evidence-based medical knowledge. This can promote the improvement of medical services, optimize doctor-patient communication, strengthen patient information support, and optimize the content of online health communities.

Fever education for caregivers in the emergency room (The FEVER study)–an interventional trial

BackgroundDespite the vast majority of fevers representing benign self-limiting illnesses, caregiver anxiety regarding fever is high. Empowering caregivers with knowledge to safely and appropriately manage fever at home has the potential to reduce demands upon healthcare services.AimTo improve caregiver knowledge about fever and its management in children via an educational intervention.MethodsCaregivers of children over 6 months presenting with fever to a Paediatric Emergency Department were recruited. A pre-intervention survey was completed to ascertain caregiver knowledge about fever and its management. The intervention of (i) an infographic about fever, with (ii) a short video on fever was viewed. A post-intervention survey re-assessed knowledge. The primary outcome was the correct definition of fever as a temperature ≥38 °C.ResultsCaregivers (n = 51) who correctly defined fever increased from 41% (n = 21) pre-intervention to 94% (n = 48) post-intervention. There was a reduction in common misconceptions about fever, including a higher fever representing a more serious infection (76% vs. 8%). Caregivers reported they were less likely to seek emergency healthcare due to the height and nature of the fever alone.ConclusionsA simple brief educational intervention can rapidly increase caregiver knowledge about fever in children. There is a continuing need for clear, easily-accessible information for caregivers on this topic.ImpactParental knowledge about fever and how to manage it in their children is low.A simple brief educational intervention can significantly increase caregiver knowledge about fever.A combined written and audiovisual approach is effective and well-received by parents.Educating caregivers has the potential to improve the management of childhood fever at home and to reduce the burden on healthcare services, as well as reduce unpleasant hospital visits for children and their caregivers.

Use of Streptococcus Salivarius K12 in a cohort of PFAPA patients.

Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis syndrome (PFAPA) is the most common cause of periodic fever in childhood. Although PFAPA is generally a self-limited condition, it can have negative impact on child's and parents' quality of life and family functioning. Our primary aim was to assess the potential effectiveness of Streptococcus Salivarius K12 (SSK12) in preventing febrile attacks in PFAPA patients. Secondary objectives included evaluating the effectiveness of SSK12 in mitigating the severity of febrile episodes seen as a statistically significant reduction in the episode duration, highest fever temperature reached during fever, in the frequency of each associated symptom, calculated in the six months before and after the start of therapy. A total of 117 patients with PFAPA were evaluated using Marshall's criteria, modified by Thomas et al. and according to Eurofever/PRINTO classification criteria, aged 6 months to 9 years, with a median age at the onset of the disease of 2 years, treated with SSK12, since January 2021 to January 2023. Data were collected retrospectively. Before using SS K12, febrile episodes recurred on average every 26.1 ± 11.5 days, with a febrile episode duration of 4.1 ± 1.4 days. The highest fever temperature during the episode was 39.8 ± 0.7 °C. After six months of SS K12, febrile episodes recurred on average every 70 ± 53,1 days (p value <0.01), the mean lenght of febrile episodes was 3.3 ± 1.6 (p value <0.01) and the highest fever temperature reached during the febrile episode was 39.1 ± 1.1 °C (p value <0.01). We also documented a reduction in the frequency of exudative pharyngotonsillitis present in 72 vs. 103 patients (p value <0.01), oral aphthosis present in 47 vs. 80 patients (p value <0.01), lateral cervical lymphadenopathy in 45 vs. 83 (p value <0.01). Erythematous pharyngotonsillitis decreased in frequency but it was not statistically significant. The results of our study indicate that the use of SS K12 could be beneficial in decreasing febrile episodes related to PFAPA syndrome and its associated symptoms, potentially improving the quality of life in pediatric patients and decreasing the need for additional pharmacological therapies.

Changing Trend of Dengue Fever in Children

Changing Trend of Dengue Fever in Children

Comparing the Effectiveness of Water Sponging Combined with Antipyretics Versus Antipyretics Alone in Lowering Fever in Children: A Systematic Review

Background: Fever occurs when the body temperature rises above normal due to external factors, such as exposure to high temperatures or heat sources. This study aims to assess the effectiveness of water sponging in combination with antipyretic versus antipyretic only on reducing body temperature in children with fever. Methods: This was a systematic review of primary studies using true experimental designs collected from online sources published between 1994 until 2024. Articles were screened using the PRISMA flow diagram with the following keywords: body temperature, children, fever, febrile, water sponging, antipyretic, randomized controlled trial. The data was reviewed accordingly. Results: The findings have revealed that three studies found no significant difference in temperature drops between tepid water sponging combined with antipyretics and antipyretics alone. Other studies, however, noted a faster initial drop with the combination, but temperatures equalized after two hours, with some children experiencing additional discomfort. Conclusion: The study concludes that while tepid water sponging combined with antipyretics initially reduces fever faster, both methods equalize within two hours, and the combination may cause additional discomfort.

Original Article Risk Factors for Enteric Fever in Children Aged 1 to 14 Years: A Cross-Sectional Study at Gandaki Province of Nepal

Introduction: Enteric fever is one of the major public health problems in Nepal. This study aimed to evaluate the risk factors associated with enteric fever in children Methods: This is prospective cross-sectional study conducted from April 15 to November 2023, with sample size of 139 children aged 1-14 years, diagnosed as enteric fever. Data were collected through pretested and validated proforma containing structured questionnaires. Data were analysed through SPSS version 23. Results: About seventy (69.8%) percent of the children had a history of consuming untreated water, and 52.5% lacked access to proper sanitation facilities. Additionally, 59% of the children were from low socioeconomic backgrounds, and 38.8% had close contact with infected individuals. The children from rural areas were more likely to be exposed to untreated water sources (73.9%) and had a higher prevalence of low socioeconomic status (62.5%) compared to their urban counterparts. Logistic regression analysis revealed that children exposed to untreated water were 2.1 times more likely to develop enteric fever than those not exposed, with this result being statistically significant (OR = 2.10, 95% CI = 1.30-3.40, p=0.002). Conclusion: Untreated water, inadequate sanitation, and low socioeconomic status as key risk factors for enteric fever in children. Rural children faced higher risks. Children exposed to untreated water were 2.1 times more likely to develop enteric fever than those not exposed, with this result being statistically significant. The findings underscore the need for improvement on water quality, sanitation, and socioeconomic conditions. Local health authorities should prioritize these areas to reduce enteric fever incidence, with further research recommended on intervention effectiveness.

Sarà veramente PFAPA?

PFAPA syndrome (Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis) is the most common periodic fever in childhood. It is a benign self-limiting condition that may resolve spontaneously during the first years of life or within adolescence, although there is increasing evidence of cases that may persist also in adulthood. A small dose of corticosteroids is safe and effective for the management of fever episodes and can also be useful for the diagnosis. Tonsillectomy is a good option for those patients who keep presenting with disabling symptoms after the typical age.

Delays in seeking treatment for fever in children under five years of age in Nigeria: Evidence from the National Demographic Health Survey.

In countries with high child mortality rates, such as Nigeria, early intervention for common childhood illnesses (e.g., pneumonia and malaria) is essential for improving clinical outcomes. The timely reporting and treatment of fever is therefore critical in making a differential diagnosis and choosing an appropriate course of treatment. The present study aimed to investigate the prevalence and major risk factors associated with delays in seeking treatment for fever in children under five years of age in Nigeria. This study used a total weighted sample of 7,466 children under five years of age from the 2018 National Nigerian Demographic and Health Survey. Multivariable binary logistic regression modelling was used to investigate the association between predisposing, enabling, need, health service and community level factors, and delay in treatment-seeking for fever. We report the delays in seeking treatment for childhood fever that was reported by mothers in the last two weeks prior to the national survey. The prevalence for delayed treatment was 62.1% (95% confidence interval [CI]: 60.1%, 64.1%). Our findings showed that there were fewer delays in seeking treatment in children aged 24-59 months (adjusted odds ratio [aOR] = 0.79, 95% CI: 0.68, 0.93), among mothers who were formally employed (aOR = 0.84; 95% CI: 0.73, 0.96), regularly attended antenatal services (aOR = 0.76, 95%CI: 0.66, 0.88), and for those who resided in wealthier households (aOR = 0.71; 95% CI: 0.56, 0.89). Children whose mothers resided in the North-West geopolitical zone of Nigeria were less likely to delay seeking treatment for fever (aOR = 0.55; 95% CI: 0.42, 0.73). However, mothers who had an unwanted pregnancy had a higher odds of delaying treatment for childhood fever (aOR = 1.58; 95% CI: 1.05, 2.39). There were significant delays in seeking treatment for childhood fever in poorer homes found in geopolitically unstable zones of Nigeria. Mothers who were poor, unemployed, and with younger children (<12 months) often delayed seeking treatment for their febrile child. Future health promotion strategies and microenterprise schemes should target both rural and urban mothers residing in poor households. Children under 12 months of age should be a priority.

Increased Rate of Familial Mediterranean Fever in Children With ADHD: A Population-Based Case-Control Study

Objective: There is growing evidence of involvement of inflammatory mechanisms in ADHD. Previous studies found significantly higher rates of ADHD among children with FMF. The present study examined the rate of exposure to FMF in children with a later (within a 5-year period) diagnosis of ADHD compared to non-ADHD children. Methods: A population-based case-control study of all children (<18 years) registered in Leumit Health Services during 01.01.2006 to 06.30.2021. All cases met ICD-9/10 criteria for ADHD. They were matched by age, sex, and socioeconomic status on a 1:2 rate to randomly selected non-ADHD controls. Results: Fifty-six (0.30%) children with ADHD (N = 18,756) were previously diagnosed with FMF compared to 65 of 37,512 controls (0.17%). A significant, independent association existed between a preceding FMF diagnosis and a later ADHD diagnosis [OR = 1.72 (95% CI 1.18–2.51); p = .003]. Conclusions: The mechanisms underlying the association w between FMF and later ADHD diagnosis merit further elucidation.

Case Report: Toxic epidermal necrolysis: a rare pediatric case report from Nepal

Toxic epidermal necrolysis (TEN) is a life-threatening cutaneous reaction to various medications like antibiotics and antiepileptics characterized by erythematous rashes, diffuse necrosis, and exfoliation of skin and mucous membranes, with a high mortality rate. Here, we present a case of six years old female child from Nepal who presented with fever and rashes, was diagnosed with measles and treated with cefixime, ibuprofen, and other drugs. Six hours after taking the drugs, the child developed generalized rashes, blisters formation, and peeling of the skin which progressed to cover most of the skin of her body within the next two days. She was then diagnosed with TEN and admitted to the Pediatric Intensive Care Unit (PICU) and treated by a multidisciplinary team with antibiotics, systemic steroids, antihistamines, wound care, and other medications. The child's fever subsided and her skin and oral lesions gradually regenerated. She was discharged after twelve days of hospitalization as she improved clinically and symptomatically. TEN is a dermatological emergency that should be diagnosed and treated promptly to minimize the fatal outcome of the disease.