A comparative study on accuracy of liquid crystal forehead, digital electronic axillary, infrared tympanic with glass-mercury rectal thermometer in infants and young children.

This study was carried out to assess the accuracy of three devices namely, liquid crystal forehead, digital electronic axillary and infrared tympanic thermometer, using a glass-mercury rectal thermometer as the control. The subjects were two hundred children aged 0-48 months. The mean rectal temperature was 38.0 +/- 0.91 degrees C; forehead, 37.83 +/- 0.94 degrees C; tympanic, 37.77 +/- 0.95 degrees C, and axillary, 37.71 +/- 0.86 degrees C. Compared to the rectal temperature, all values were significantly lower (p < 0.05). Forehead, tympanic and axillary temperature differed from rectal temperature by at least 0.5 degrees C in 33.33 per cent, 23.5 per cent and 31.5 per cent of subjects, and at least 1 degrees C in 22 per cent, 1 per cent and 6 per cent of subjects respectively. Accuracy in detection of fever was 79 per cent for forehead, 85.5 per cent for tympanic and 84 per cent for axillary thermometry. Sensitivity of the three devices was 67-83 per cent in detection of fever and 64-77 per cent in detection of high fever. Tympanic thermometry had the best performance while forehead thermometry had the poorest. After using revised diagnostic threshold temperature by ROC curves, sensitivity of each device improved but accuracy was nearly the same. It is concluded that the three devices are not suitable as a substitute for a glass-mercury rectal thermometer in assessment of fever in infants and young children.

Allergen skin test reactivities among asthmatic Thai children.

Skin prick tests with 14 selected local aeroallergens were performed on 100 asthmatic children aged 0-16 years attending the Pediatric Allergy Clinic, Faculty of Medicine, Siriraj Hospital. The 14 allergens included Dermatophagoides farinae, Dermatophagoides pteronyssinus, American cockroach (Periplaneta americana), Johnson grass (Sorghum halopense), Cladosporium clarosporoides, Alternaria tenuis, Penicillium mix, Aspergillus mix, cat dander, dog dander, milk, egg white, soy and shrimp. Positive skin test reactivity was defined as a mean wheal diameter > or = 3 mm at the 20 minute reading. There were 68 males and 32 females. Their ages were between 0-2 years (n = 1), 2-5 years (n = 19), 5-10 years (n = 49) and 10-16 years (n = 31). Of all the subjects, 22 were classified as having mild asthma, 74 with moderate asthma and 4 with severe asthma. At least one skin prick test was positive in 74 subjects (74%) and two positive tests in 66 subjects (66%). The prevalence of sensitization to various allergens was as follows; Dermatophagoides pteronyssinus 67%, Dermatophagoides farinae 62%, American cockroach 44%, shrimp 14%, Johnson grass 14%, cat dander 10%, Alternaria 7%, Cladosporium 7%, dog dander 5%, soy 4%, Penicillium 3%, Aspergillus 2%, milk 2% and egg white 1%. The wheal size to Dermatophagoides pteronyssinus did not correlate with age. In this group of asthmatic Thai children, house dust mites are the most important allergen causing sensitization.