非洲儿童发热评估：对疟疾试验的影响。
Assessment of fever in African children: implication for malaria trials.
机构信息
Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon.
出版信息
Am J Trop Med Hyg. 2010 Feb;82(2):215-8. doi: 10.4269/ajtmh.2010.09-0419.
Abstract
We evaluated methods for assessing body temperature by comparing subjective assessment of fever by parents and doctors with objective axillary, tympanic, and rectal measurements of body temperature in 1000 children < or = 10-years-old who presented at outpatient clinics with recent history of fever. Sensitivity of subjective assessment of fever were higher at thresholds of > or = 38.3 degrees C with specificity as low as 60%. Axillary methods showed better specificity at fever thresholds of > 38.0 degrees C with maximum sensitivity of 63% at thresholds of > or = 37.5 degrees C. Bland-Altman analysis showed wide limits of agreement between objective methods of measurements: -1 degrees C to 3 degrees C for comparison of rectal and axillary, -1 degrees C to 2 degrees C for rectal and tympanic, and -1 degrees C to 2 degrees C for tympanic and axillary measurements. A choice of method to measure body temperature for diagnosis of fever in African children should be informed by a trade-off between its specificity and sensitivity that considers thresholds > 38.0 degrees C.
摘要
我们评估了通过比较父母和医生对发热的主观评估与腋温、鼓膜和直肠体温的客观测量来评估体温的方法，共纳入了 1000 名< 10 岁的因近期发热而到门诊就诊的儿童。在发热阈值为> = 38.3°C 时，主观评估发热的敏感性更高，特异性低至 60%。腋温法在发热阈值为> 38.0°C 时显示出更好的特异性，在阈值为> = 37.5°C 时敏感性最高为 63%。Bland-Altman 分析显示客观测量方法之间的一致性界限较宽：直肠和腋温比较为-1°C 到 3°C，直肠和鼓膜比较为-1°C 到 2°C，鼓膜和腋温比较为-1°C 到 2°C。选择用于诊断非洲儿童发热的体温测量方法应根据其特异性和敏感性之间的权衡来决定，考虑到阈值> 38.0°C。
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