Causes, Fever In Children Under 5Years Knowledge, Attitude and Practices of Mothers And Health Team Towards The Management of Acutely Febrile Children

Abstract

This is a cross sectional hospital based study conducted during the period of July, August and September 2003 including pediatric casualties and units of KECH, KTH, KNTH, Omdurman TH and Ahmed Gasim PTH. The study included 268 acutely febrile children under 5 years, 292mothers, 75 doctors , 123 nurses. The main objectives were determining causes of fever in children and assessing knowledge, attitude and practices of mothers, doctors and nurses towards management of febrile child. The most common causes of fever in the study group were respiratory tract infections (61.5%) and malaria in (15.7%). Less common were diarrhoeal diseases (07.1%), otitis media (03.7%), urinary tract infections (02.2%), measles (03.7%), urinary tract infections (02.2%) , measles (02.6%) and (07.1%) were other causes such as osteomyelitis, meningitis and viral infections. Mothers show poor knowledge about fever. Few mothers (1%) believe that fever is beneficial. Only (15%) can define it in terms of degrees. They treat it aggressively, worry about it and utilize harmful practices. It is found that cold sponging is used by two thirds of them (66.1%), one third use sponging as the first line of treatment, (12.4%) still use aspirin as antipyretic and high proportion used to practice self treatment of fever by drugs. There was significant correlation of mother’s knowledge attitudes and practices with educational level. Highly educated mothers have better knowledge, attitude and practices than low educated mothers. vi Few mothers (3.1%) use traditional methods to treat fever at home. The common traditional means were covering the febrile child’s skin surface with sesame oil for which other herbal materials can be added like garad or kammon. Other means lubkha, duckan, cauterization, scarring and uvula removal. There was significant difference in knowledge and attitude between house officers medical officers. and registrars. The later have better knowledge than house officers and medical officers. About fifty four percent of doctors in the study were house officers , (22.7%) were medical officers and registrars were also (22.7%). Most of them 70.7% know the cut-off level of fever, but high proportion (60%) don’t know the pathophysiology of fever and treat fever to prevent convulsions. Only a small percentage (22.7%) is familiar with different antipyretic forms, concentrations and doses. (34%) of the doctors did not have teaching about fever in there under graduate teaching Nurses included in the study have great deficiency in knowledge about thermometers and only one fourth (24.6%) of them measure temperature correctly. In the study area which includes 46 facilities, there is one thermometer per one facility in 18facilities (39.1%) and only 10.8% had temperature chart.