Fever detection in under 5 children in a tertiary health facility using the infrared tympanic thermometer in the oral mode

This study was aimed at using the infrared tympanic thermometer (IRTT) in oral mode to measure temperature in febrile and afebrile children less than 5 years.Rectal and tympanic temperatures were measured consecutively in 400 febrile and 400 afebrile under-5 children matched for age, using the mercury-in-glass thermometer and the IRTT in oral mode respectively.In the febrile children, the mean tympanic temperature was 38.6 ± 0.9°C, while the mean rectal temperature was 39.0 ± 0.8°C. In the afebrile group, the mean tympanic temperature was 37.0 ± 0.4°C, while the mean rectal temperature was 37.4 ± 0.3°C. The mean difference between rectal and tympanic temperatures in both groups was statistically significant. There was good correlation between the two temperatures. The tympanic thermometer used in the oral mode had a sensitivity of 87.3% and a specificity of 96.5%.The IRTT (oral mode) may not be reliable in estimating 'core' body temperature in children under the age of five years, but with a fairly good sensitivity and specificity, as well as its other advantages such as short duration of measurement, convenience and safety, it is a useful instrument for screening children with fever in a busy setup.The best site to measure 'core' temperature is the temperature regulating centre situated in the hypothalamus, but since this is not feasible, body sites that most closely approximate the 'core' temperature provide the most accurate readings [1]. The pulmonary artery, oesophagus, trachea, nasopharynx and bladder have all been used in anaesthetized patients [2]. However, access to these sites require invasive procedures and are not feasible for routine clinical use, hence the use of rectal temperature as the 'gold standard' in most clinical settings [3,4]. Apart from the rectum, the oral cavity and axilla have traditionally been used to take temperature in children, using mercury- in -glass thermometer. In recent years, however, the use of mercury thermometers has been di