Comparison of Infrared Tympanic and Digital Electronic Axillary Thermometers with Glass-Mercury Rectal Thermometers in Thai Children

Abstract

          This prospective observational study assessed the accuracy and factors that influenced the infrared tympanic and digital electronic axillary thermometers compared with glass mercury rectal thermometers in 200 Thai children aged 1 day - 48 months in Nakhonpathom Hospital. Temperature measurements were obtained simultaneously at three body sites with infrared tympanic (rectal mode), digital electronic axillary and glass-mercury rectal thermometers three times for each thermometer and determined averaged values. The mean rectal temperature (38.00 ± 0.91°C) was higher than the mean tympanic (37.77 ± 0.95°C) and the mean axillary temperature (37.71 ± 0.86°C) significantly (p < 0.05). Rectal temperatures showed excellent correlation with both tympanic and  axillary temperatures (r = 0.93 and 0.90, respectively, p < 0.001). In detecting fever, tympanic thermometer was 72% sensitive, 98% specific and 85.5% accurate. Axillary thermometer was 68% sensitive, 99% specific and 84% accurate. Quantity of cerumen and acute otitis media had no effect on the accuracy of the tympanic thermometer. Range of rectal temperature, age group and ambient temperature influenced on the accuracy of digital axillary thermometer more than tympanic thermometer. Tympanic thermometer had slightly better performance than axillary thermometer. Because of low sensitivity, both thermometers should not be substituted for glass-mercury rectal thermometer in newborn infants and young children now.