TEPID SPONGING TO REDUCE TEMPERATURE IN FEBRILE CHILDREN IN A TROPICAL CLIMATE

The effectiveness of tepid sponging, in addition to antipyretic medica tion, in the reduction of temperature in febrile children living in a tropical environment, was assessed in a prospective, randomized, open trial. Seventy-five children aged between 6 and 53 months who attended the casualty department of the Children's Hospital, Bangkok, Thailand , with fever (rectal temperature greater than or equal to 38.5 degrees C) of presumed viral origin were randomized to receive either tepid s ponging and oral paracetamol (sponged group) or paracetamol alone (con trol group). Rectal temperature and the occurrence of crying, irritabi lity, and shivering were recorded over the following 2 hours. A greate r and more rapid fall in mean rectal temperature occurred in the spong ed group than in the control group. Temperature fell below 38.5 degree s C sooner in children in the sponged group than in control children ( P < 0.001). At 60 minutes, 38 (95.0%) of the controls still had a temp erature of 38.5 degrees C or greater, compared with only 15 children ( 42.9%) in the sponged group (P < 1x10(-5)). Crying was associated with sponging, but shivering and irritability occurred in only one child w ho was being sponged. It is concluded that tepid sponging, in addition to antipyretic medication, is clearly more effective than antipyretic medication alone in reducing temperature in febrile children living i n a tropical climate.