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Prise en charge de la fièvre de l'enfant : les connaissances et pratiques des parents sont-elles satisfaisantes ?
Authors:J-M Boivin  F Weber  R Fay  P Monin
Institution:1. MCA, département de médecine générale, faculté de médecine de Nancy, université Henri-Poincaré, centre d''investigation clinique, Inserm, CHU de Nancy, hôpital Jeanne d''Arc, BP 90303, 54201 Toul cedex, France;2. Département de médecine générale, faculté de médecine de Nancy, université Henri-Poincaré, Nancy, France;3. Biostatisticien, centre d''investigation clinique, Inserm, CHU de Nancy, Nancy, France;4. PU-PH, CHU de Brabois, UHP, Nancy, France;1. École de santé publique, département de biostatistique, Université libre de Bruxelles (ULB), campus Erasme, route de Lennik 808, 1070 Bruxelles, Belgique;2. Service d’épidémiologie et contrôle des maladies parasitaires, Institut de médecine tropicale Prince-Léopold, Anvers, Belgique;3. École de santé publique, département d’épidémiologie et médecine préventive, Université libre de Bruxelles, Bruxelles, Belgique;4. Unité de santé internationale, département des sciences de la santé publique, université de Liège, Liège, Belgique;5. Centre scientifique et médical de l’Université libre de Bruxelles pour ses activités de coopération (CEMUBAC), Bruxelles, Belgique;6. Département de nutrition, centre de recherche en sciences naturelles, Lwiro, République démocratique du Congo;1. Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble, France;2. INSERM U1042, Hypoxia and Physiopathology Laboratory, Joseph Fourier University, Grenoble, France;1. Service d’urgences pédiatrique, hôpital Armand-Trousseau, Assistance publique–Hôpitaux de Paris, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France;2. AFPA, Inserm-CIC 201, cabinet de pédiatrie, 46, cours F.-Roosevelt, 69006 Lyon, France;3. Cabinet de pédiatrie, 30, avenue Victor-Cresson, 92130 Issy-Les-Moulineaux, France;4. Université Pierre-et-Marie-Curie, Paris VI, 75006 Paris, France;1. Département de médecine générale, faculté de médecine de Nancy, université de Lorraine, 9, avenue de la forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France;2. CIC-P-Inserm, CHU de Nancy, 54000 Nancy, France;3. Pôle S2R, épidémiologie et évaluation clinique, CHU de Nancy, 54000 Nancy, France;1. Florence Nightingale Faculty of Nursing and Midwifery, King''s College London, James Clerk Maxwell Building, 57 Waterloo Road, London SE1 8WA, United Kingdom;2. Florence Nightingale Faculty of Nursing and Midwifery, King''s College London, United Kingdom
Abstract:Paediatric fever is a frequent reason of consulting a paediatrician or a general practitioner (30% of paediatric consultations). AIM OF THE STUDY: This investigation aimed at reporting the knowledge level concerning child's and infant's fever in a urban population and the resulting practices. Two thousand and six hundred questionnaires were distributed in June 2004 in the 29 scholar institutions of Metz agglomeration (France) classified in 3 categories according to socio-economical conditions of parents: 3 institutions of city centre (high socioeconomical conditions), 18 sub-urban institutions (intermediary conditions) and 8 institutions located in priority education zones (ZEP) (defavorable conditions). RESULTS: One thousand and thirty-eight questionnaires could be analyzed (40%): 176 in city centre, 634 in sub-urban zones and 228 in ZEP. Fever threshold at 38 degrees C is well-known and fever measuring methods used are mostly in accordance with the recommendations. The best room temperature was known and the use of antipyretic physical means underlined only a few cases of obvious mistakes. All parents were informed about worrying signs related with fever even if doctor's resort was excessive. Acetaminophen was the reference molecule before ibuprofen whereas the use of aspirin was decreasing. Antipyretic treatments methods used by parents were often unsuitable, leading to therapeutical inefficacy, overdosage or noxious drug interactions, mainly because of a lack of knowledge about drug components. CONCLUSION: This investigation underlines insufficient knowledge and noxious management practices among parents with unfavourable socio-economical conditions which lead us to recommend targeted information preferentially in areas gathering together most unfavourable socio-economical condition populations.
Keywords:
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