■我们在低资源中搜索了最合适的测温方法,塞拉利昂的热带环境,无论是在准确性方面,还是在患者和用户接受度方面。
■我们对不同的体温测量方法进行了前瞻性比较研究。每个参与者都通过四种不同的方法测量温度:非接触式红外温度(NCIT),腋窝,鼓膜和直肠测量。直肠温度被认为是临床金标准。主要结果是测温方法在检测发烧(直肠温度≥38.0°C)中的预测敏感性和特异性。使用问卷调查来探索患者和医护人员对不同温度测量方法的态度。
■从562名参与者中获取824个直肠体温读数。平均直肠温度为37.4°C(IQR37°C至37.7°C),最低读数为35.2°C,最高读数为41.0°C。鼓膜测温显示使用Genius3TM温度计检测发热的灵敏度最高(灵敏度为70.8%,95%CI60.2%-79.9%;特异性97.2%,95%CI95.5-98.4%);和BraunTM(灵敏度51.5%,95%CI42.6%-62.0%;特异性98.8%,95%CI97.7-99.5)。NCIT测温灵敏度较低(使用的两种设备为36.8%-41.4%)。腋窝测温灵敏度为40.6%。参与者将NCIT列为最多,将直肠列为最不喜欢的方法。来自32名参与护士的问卷调查显示同意使用NCIT,常规TM和腋窝法,但直肠测温就不那么重要了.
■当将不同测温方法检测发热的准确性与用户和患者的可接受性相结合时,鼓膜测温法似乎最合适,但也有局限性。
UNASSIGNED: We searched for the most-suitable
thermometry method in the low-resource, tropical setting of Sierra Leone, both in terms of accuracy and also patient and user acceptance.
UNASSIGNED: We conducted a prospective comparative
study of different methods of body temperature measurement. Each participant had their temperature taken by four different methods: non-contact infrared temperature (NCIT), axillary, tympanic membrane and rectal measurements. Rectal temperature was considered clinical gold standard. Primary outcome was predicted sensitivity and specificity of
thermometry methods in detecting fever (rectal temperature ≥38.0 °C). Questionnaires were used to explore patient and healthcare worker attitudes towards different methods of temperature-taking.
UNASSIGNED: 824 rectal body temperature readings were taken from 562 participants. The mean rectal temperature was 37.4 °C (IQR 37 °C to 37.7 °C), with a minimum reading of 35.2 °C and maximum of 41.0 °C. Tympanic membrane thermometry showed the highest sensitivity of fever detection using the Genius3 TM thermometer (sensitivity 70.8 %, 95 % CI 60.2%-79.9 %; specificity 97.2 %, 95 % CI 95.5-98.4 %); and Braun TM (sensitivity 51.5 %, 95 % CI 42.6%-62.0 %; specificity 98.8 %, 95 % CI 97.7-99.5). NCIT
thermometry sensitivity was low (36.8 %-41.4 % for the two devices used). Axillary
thermometry sensitivity was 40.6 %. Participants ranked NCIT as the most and rectal as the least preferred method. Questionnaires from 32 participating nurses showed agreeability to using NCIT, TM and axillary methods routinely, but less so for rectal thermometry.
UNASSIGNED: When combining the accuracy of different thermometry methods in detecting fever with user and patient acceptability, tympanic membrane thermometry appears most suitable but also has limitations.