Comparison of cold water sponging and acetaminophen in control of fever among children attending a tertiary hospital in South Nigeria

Abstract

Background:A wide range of childhood illnesses are accompanied by fever, leading to varied attempts at treatment by caregivers at home before coming to a hospital. Common modalities of treatment include use of antipyretics and physical methods such as cold water sponging, fanning and removal of clothing. These treatment modalities have been received with varied attitudes among physicians and the scientific community. This study was to assess the efficacy of both modalities in first-line management of fever in our area.Objectives:The main aim of the study is to compare the effectiveness of cold water sponging with that of oral paracetamol in the treatment of fever in children attending the University of Calabar Teaching Hospital, Calabar.Subjects and Methods:This is a randomized clinical trial. Eighty-eight children aged 12-120 months who presented to the Children Outpatient Clinic (CHOP) and the Children Emergency Room (CHER) of University of Calabar Teaching Hospital, Calabar, with acute febrile illness and axillary temperatures spanning ≥ 38.0-40.0°C. All children within the age limit whose caregivers gave consent were recruited into the study and were randomized to receive either cold water sponging or oral paracetamol. Axillary temperature, pulse rate, respiratory rate and assessment of discomforts (crying, shivering, goose pimples and convulsions) were recorded every 30 min for 2 h. The results were analyzed using the SPSS statistical software and have been presented in the tables.Results:Cold water sponging was very effective in temperature reduction within the first 30 min, with 29 (70.73%) having their temperature reduced to within normal limits. This declined to 12 (29.26%) at 60 min and 4 (10.53%) at 120 min, with the mean temperature differences from the baseline value following the same trends (1.63°C by 30 min, 0.91°C by 60 min and 0.39°C by 120 min). When compared with paracetamol, cold water sponging was more effective in temperature reduction within the first 30 min (P = 0.000), with the difference in effect at 60 min less significant between these two groups (P = 0.229). Paracetamol demonstrated a gradual and sustained reduction in temperature with the proportions of afebrile children in this group increasing from 7 (16.27%) at 30 min to 33 (78.57%) at 120 min. The mean temperature differences from the baseline value also showed the same trend. Children who received cold water sponging had more discomforts compared with those who received only oral paracetamol.Conclusions:It is concluded that cold water sponging, although producing rapid reduction in temperature compared with paracetamol, has effects that last only for a short time. Paracetamol on the other hand produces a gradual but sustained effect. The discomforts experienced should not be a limiting factor to the use of cold water sponging in reducing the body temperature of febrile children. Cold water sponging is safe and its use by mothers and primary caregivers should be encouraged while preparing to take the child to the nearest health ...

Repeated sampling improved the sensitivity of malaria microscopy in children under six years

“…Repeat smears, conducted at 6 and 12 h after admission increased the diagnostic yield considerably, with an additional 21 (11.9%) children diagnosed smear positive. Even though tepid sponging and the use of antipyretics were expected to significantly reduce body temperature within an hour [ 15 ], axillary temperature of 37.7–37.8 °C was obtained for the additional patients in which malaria parasite were confirmed. Strikingly, the cumulative detection rate of malaria microscopy up to 12 h of initial negative parasitological results was very comparable to the detection rate of baseline RDT ( x 2 = 0.046, p = 0.83).…”

Manejo não farmacológico da febre e hipertermia da criança: revisão integrativa

“…Aluka TM et al 2013 . (37) 1B Investigar a eficácia da sponging fria comparada ao uso oral do paracetamol no tratamento da criança febril.…”

“…(1,24,28) A temperatura da água pode variar desde o valor abaixo da temperatura corpórea da criança até o limite de 33°C. (24,28,37) Em diversas pesquisas, a sponging morna tem sido utilizada em conjunto com um antitérmico. (1,7,14,(16)(17)(18)(19)(23)(24)(25)(26)(27)(28)(29) A intervenção conjugada, sponging morna e antitérmico, obtém parecer favorável apenas quando o uso tem como objetivo principal oferecer conforto à criança.…”

Analysis of public health students’ knowledge on health effects of thermoneutral, hot and cold water

“…It is further known that the home remedy of cold water sponging is used on febrile child to produce rapid temperature reduction although the use of Paracetamol over the counter medication works faster. 13 Hot water compress on the lumber region can aid defecation during hydrotherapy but care must be taken to avoid scalding in children. 4 In addition, alternating hot and cold compresses have been used very effectively in reducing pain and breast engorgement in post -natal mothers.…”