Is tepid sponging more effective than paracetamol at relieving fever in febrile children in hot tropical climates? a mini review.

Background: Childhood fever remains a significant health problem because of the convulsion risk it poses to the child as well as the parental anxiety it provokes. Tepid sponging of such children remains commonplace in tropical climates despite the lack of evidence to support it. Objective: To evaluate the effectiveness of tepid sponging in hot tropical climates. Methods: NICE systematic review methodology was used. Medline and EMBASE were searched from their inception to date. Eligibility criteria included a) studies of randomised controlled trial (RCT) design b) children aged 2 to 120 months c) the use of tepid sponging alone in one arm and paracetamol in the other arm of the experiment. Eligible studies were critically appraised with NICE risk of bias tool. The outcome of interest was the number of afebrile children 2 hours after intervention. The outcome data from eligible studies were pooled for meta-analysis using random effects. Findings: Out of the 201 papers retrieved from the electronic search, two studies met the inclusion criteria. The meta-analysis found that tepid sponging was less effective than paracetamol at relieving fever two hours post-intervention (RR=0.25, 95% CI 0.08-0.79]). Conclusion: Tepid sponging was not effective against fever. There is the need to modify existing local clinical protocols to reflect the new evidence and international guidelines. Funding: None declared.