TY - JOUR
T1 - Human touch vs. axillary digital thermometry for detection of neonatal hypothermia at community level
AU - Agarwal, Siddharth
AU - Sethi, Vani
AU - Pandey, Ravindra Mohan
AU - Kondal, Dimple
N1 - Funding Information:
This study was supported by a Junior Research Fellowship grant no. F. 11-14/2003 (SA-I) received from University Grants Commission, New Delhi to the second author of this article.
PY - 2008/6
Y1 - 2008/6
N2 - We examined the diagnostic accuracy of human touch (HT) method in assessing hypothermia against axillary digital thermometry (ADT) by a trained non-medical field investigator (who supervised activities of community health volunteers) in seven villages of Agra district, Uttar Pradesh, India. Body temperature of 148 newborns born between March and August 2005 was measured at four points in time for each enrolled newborn (within 48 h and on days 7, 30 and 60) by the field investigator under the axilla using a digital thermometer and by HT method using standard methodology. Total observations were 533. Hypothermia assessed by HT was in agreement with that assessed by ADT (<36.5°C) in 498 observations. Hypothermia assessed by HT showed a high diagnostic accuracy when compared against ADT (kappa 0.65-0.81; sensitivity 74%; specificity 96.7%; positive predictive value 22; negative predictive value 0.26). HTis a simple, quick, inexpensive and programmatically important method. However, being a subjective assessment, its reliability depends on the investigator being adequately trained and competent in making consistently accurate assessments. There is also a need to assess whether with training and supervision even the less literate mothers, traditional birth attendants and community health volunteers can accurately assess mild and moderate hypothermia before promoting HT for early identification of neonatal risk in community-based programs.
AB - We examined the diagnostic accuracy of human touch (HT) method in assessing hypothermia against axillary digital thermometry (ADT) by a trained non-medical field investigator (who supervised activities of community health volunteers) in seven villages of Agra district, Uttar Pradesh, India. Body temperature of 148 newborns born between March and August 2005 was measured at four points in time for each enrolled newborn (within 48 h and on days 7, 30 and 60) by the field investigator under the axilla using a digital thermometer and by HT method using standard methodology. Total observations were 533. Hypothermia assessed by HT was in agreement with that assessed by ADT (<36.5°C) in 498 observations. Hypothermia assessed by HT showed a high diagnostic accuracy when compared against ADT (kappa 0.65-0.81; sensitivity 74%; specificity 96.7%; positive predictive value 22; negative predictive value 0.26). HTis a simple, quick, inexpensive and programmatically important method. However, being a subjective assessment, its reliability depends on the investigator being adequately trained and competent in making consistently accurate assessments. There is also a need to assess whether with training and supervision even the less literate mothers, traditional birth attendants and community health volunteers can accurately assess mild and moderate hypothermia before promoting HT for early identification of neonatal risk in community-based programs.
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U2 - 10.1093/tropej/fmm098
DO - 10.1093/tropej/fmm098
M3 - Article
C2 - 18156647
AN - SCOPUS:45149083300
SN - 0142-6338
VL - 54
SP - 200
EP - 201
JO - Journal of tropical pediatrics
JF - Journal of tropical pediatrics
IS - 3
ER -