![]() These observations were consistent with the observations in a systematic review by Craig et al. This may be explained by the smaller “core – shell” difference in neonates when compared to older children. The mean “recto–axillary” temperature difference was least in neonates. The mean axillary readings differed significantly from the mean rectal temperature readings across all age groups. The relationship between the two methods of temperature measurement was determined using the Pearson's correlation coefficient at 99% confidence limit. A P-value of less than 0.05 was considered statistically significant. The mean differences between rectal and axillary temperatures were compared using the Student t-test. Rectal temperature was used as a reference standard to compare axillary temperature. The data was analyzed with the computer, using the SPSS-15 software. ![]() The axillary mercury-in-glass thermometers were cleaned with cotton wool swab soaked in methylated spirit. Each rectal mercury-in-glass thermometer was used only once each day and properly cleaned thereafter by washing with detergent and soaking in bleach for several hours before rinsing properly and drying. The thermometers were standardized by placing in warm water bath and ensured that all readings were the same before use each day. All thermometers were well reset before each measurement.Īll the children with fever were investigated and treated as appropriate for each child. Care was taken in each case to prevent breakage of the thermometers. The axillary mercury-in-glass thermometer was inserted with the tip at the apex of the axilla and the arm held firmly at the side by the mother/caregiver for 5 min in neonates and 7 min in older children. The rectal mercury-in-glass thermometer was lubricated with a water-soluble lubricant and inserted to a depth of 2-3 cm in neonates and 5-6 cm in older children and left for 3 min and 5 min respectively in neonates and older children before removal for reading. The rectal and axillary thermometers were placed simultaneously with the child lying on his/her side on the couch or prone on the mother's laps. Written consent was also obtained from the parents or guardians. 5Īpproval from the research and ethics committee of the hospital was obtained. While for axillary temperature fever was defined as ≥37.5☌ for neonates and ≥37.6☌ for children beyond the neonatal age group. They were grouped into two using their rectal temperatures: 400 febrile and 400 afebrile children.įever in this study was defined as rectal temperatures of ≥37.6☌ in neonates and ≥38.0☌ in the older children. This study was therefore aimed at establishing the relationship between the two sites using children less than 5 years and also validating or otherwise some of these equations by comparing the temperatures taken simultaneously in these two sites.Įight hundred children aged less than 5 years (birth – 59 months) were recruited from the children's outpatient (CHOP), children emergency room (CHER) the follow-up clinics and the well baby/immunization clinic of the University of Nigeria Teaching Hospital, Enugu. Several equations have been deduced to explain the relationship between axillary and rectal temperatures. Several researchers have tried to do an intersite comparison of body temperatures with different outcomes in relationships. Many clinicians have continued to use and recommend the site for fever screening 5, 6 One pertinent question is: Can the axillary temperature be used to predict rectal temperature? Traditional information handed on from different generations of health practitioners is that axillary temperature is 1☌ less than rectal temperature. The axillary temperature is easily accessible, safe, hygienic, and simple. Unfortunately, rectal thermometry has been resented by many children and their parents 4, leaving axillary thermometry as the only option in many cases, especially the under-5 children. ![]() However, since these sites are clinically inaccessible, clinicians have utilized the rectum as a practical site that most closely reflects core temperature despite some of its drawbacks like rectal perforation in neonates, spread of infections, and slow response to temperature changes 3. 2 Other alternative sites which have been used, including distal esophagus, bladder, and nasopharynx, are accurate within 0.1-0.2☌ of core temperature. 1 Since the hypothalamus is inaccessible, the core temperature is generally defined as the temperature measured within the pulmonary artery. The best sites for measuring body temperature are those closest to the hypothalamus, the temperature regulating center that reflects the “core” temperature. It is a crucial clinical assessment in the care of an acutely ill child. Body temperature measurement is one of the most common procedures carried out in the Pediatric clinic. ![]()
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