Causes of acute febrile illness among school children in ladkrabang district, Bangkok: cohort study

Abstract

Fever is a common clinical sign of most infectious diseases. School children are a population at risk, and also play an important role as a source of disease outbreak spreading in community. This study aimed to describe and investigate causes of acute febrile illness among school absentees Study was conducted in seven primary schools containing 5000 students from Ladkrabang district, Bangkok between 1 November 2013 and 31 August 2014. School absentees were monitored by an electronic absenteeism system. A list of school children who were sick with fever for 2 consecutive days were extracted and sent to nurses who are responsible for home visits. During home visits, consenting children and their parents were asked to complete a questionnaire. Sick children were also tested for dengue infection using a dengue duo rapid test. Their parents were advised to take their children to see a doctor for further investigation and treatment. One week later, the parents were asked for a final diagnosis of their sick children via phone. 60 % of the 83 investigated sick children received self-medication and recovered without seeing a doctor. The most common clinical signs were headache (64%). No dengue infection results were found. The top cause of acute febrile illness was the common cold (36%). Most parents preferred to give self-medication, maybe due to most students not having serious illnesses. No positive dengue test results were possibly due to the low incidence of infection. Understanding pattern of acute febrile illness in this population would greatly help to prevent disease outbreaks in schools and communities.