Comparison of body temperatures taken at different sites and the reliability of axillary temperature in screening for fever.

This prospective study was carried out to compare temperatures taken at different sites and also to determine the reliability of axillary temperatures in screening for fever in healthy and febrile children under 10 years of age. The difference between the mean rectal and axillary temperatures was not significant in both healthy and febrile neonates (P > 0.05). However, in healthy and febrile children beyond the neonatal period the mean rectal temperature was significantly higher than the mean axillary temperature (P < 0.001), the difference between the mean axillary and oral temperatures was significant (P < 0.001) but there was no significant difference between the mean oral and mean rectal temperatures (P < 0.05). The mean axillary temperature stabilisation time was 3.8 minutes while the mean rectal and oral temperature stabilisation times were 1.6 minutes and 1.8 minutes respectively. The sensitivity of axillary temperatures in detecting fever was 98% among neonates but only 47% among children beyond the neonatal period. The specificity and positive predictive value were 100% each among both the neonates and children beyond the neonatal period. The negative predictive value was 98.7% among neonates while it was 64.4% amount the older children. It is concluded that unlike in older children axillary temperature in neonates correlates well with the core temperature and it is sensitive enough to detect fever. Axillary temperatures rather than rectal temperatures should be taken in neonates, while rectal or oral temperatures be taken in older children. When the axillary route is used, the thermometer should be left in place for at least 4 minutes.