Human Touch vs. Axillary Digital Thermometry for Detection of Neonatal Hypothermia at Community Level

Agarwal S, Sethi V, Pandey RM, Kondal D: Human touch vs. axillary digital thermometry for detection of neonatal hypothermia at community level. J Trop Pediatr.June, 2008, 54: 2. DOI: 10.1093/tropej/fmm098; PMID:18156647

2 Pages Posted: 15 Jun 2016

See all articles by Siddharth Agarwal

Siddharth Agarwal

Urban Health Resource Centre; Dept. of International Health, JHBSPH

Vani Sethi

Urban Health Resource Centre

Ravindra Pandey

All India Institute of Medical Sciences (AIIMS) - Department of Biostatistics

Dimple Kondal

All India Institute of Medical Sciences (AIIMS)

Date Written: June 1, 2008

Abstract

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 hypothermia assessed by axillary method (<36.5_C) in 498 out of the 533 observations. There were only 35 (6.7%) mismatched measurements. Kappa value of 0.73 (95% confidence interval 0.65–0.81) showed a good agreement between the two tests. The sensitivity and specificity of HT method to correctly identify hypothermic (true positive) and non-hypothermic babies (true negative) was 74% and 96.7%, respectively. A positive and negative likelihood ratio of 22 (cut off >9) and 0.26 (cut off <0.5), respectively, also indicated that HT had a high diagnostic accuracy

HT is 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.

Keywords: India, rural communities, newborn care, less-literate mothers, newborn sickness

JEL Classification: D10, D19, I1, I10, I12,I3, I30, I31, J13, R20, Z10

Suggested Citation

Agarwal, Siddharth and Sethi, Vani and Pandey, Ravindra and Kondal, Dimple, Human Touch vs. Axillary Digital Thermometry for Detection of Neonatal Hypothermia at Community Level (June 1, 2008). Agarwal S, Sethi V, Pandey RM, Kondal D: Human touch vs. axillary digital thermometry for detection of neonatal hypothermia at community level. J Trop Pediatr.June, 2008, 54: 2. DOI: 10.1093/tropej/fmm098; PMID:18156647, Available at SSRN: https://ssrn.com/abstract=2795291

Siddharth Agarwal (Contact Author)

Urban Health Resource Centre ( email )

136, Humayunpur, First Floor
Safdarjung Enclave
New Delhi, Delhi 110029
India
911126199771 (Phone)

HOME PAGE: http://uhrc.in/name-CmodsDownload.html

Dept. of International Health, JHBSPH ( email )

Wolfe Street
Baltimore, MD 21205
United States

Vani Sethi

Urban Health Resource Centre ( email )

136, Humayunpur, First Floor
Safdarjung Enclave
New Delhi, Delhi 110029
India

Ravindra Pandey

All India Institute of Medical Sciences (AIIMS) - Department of Biostatistics ( email )

India

Dimple Kondal

All India Institute of Medical Sciences (AIIMS) ( email )

Aurobindo Marg
Ansari Nagar East
New Delhi, New Delhi 110029
India

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