Fever

Problems and possible causes

When a person's body temperature is too high, they have a fever. Fever is not a disease in itself but a sign that something is wrong in the body. Fever may indicate one of many different illnesses.

High fever can be dangerous, especially in small children. Fever as a symptom can make anyone feel very uncomfortable.

In people with AIDS fevers often come and go. It is difficult to know whether the fever is a symptom of a treatable infection or whether it is due to the HIV infection itself. The causes of fever include:

· AIDS-related opportunistic infections, such as tuberculosis
· endemic diseases, such as malaria
· HIV infection itself.

It is important to identify tuberculosis as early as possible because it can be easily spread to others in the home, especially to children. See Chapter Six for more information about tuberculosis.

What to do at home

The best way to check whether someone has a fever is to use a thermometer and measure their temperature. If you do not have a thermometer you can still get an idea of whether someone has a fever by putting the back of your hand on their forehead and the back of your other hand on your forehead. If they have a fever, you should be able to feel the difference.

Figure

How to lower a fever

· Remove any unnecessary clothing and blankets; fresh air (for example from a breeze) is not harmful and helps to lower the fever.

· Cool the skin by taking baths or pouring water on it, putting cloths soaked in water on the chest and forehead and fanning the cloths, or just wiping the skin with wet cloths and letting the water evaporate.

Figure

· Provide plenty of water, weak tea, broth or juice. When someone has a fever they lose more fluids than usual and this can make them feel worse, and can cause them to become dehydrated.

· Use medicines that reduce fever (antipyretics): for example, aspirin or paracetamol, two tablets every eight hours. For children the dose is lower and depends on size (weight) or age. See Chapter Seven for specific information about these medicines.

How to manage the discomfort of fever

· In between bathing and cooling the skin to lower the fever, keep the skin clean and dry.
· Use lotions or powders to prevent skin problems such as rashes, sores, sore areas or broken areas.

When sick people and their families must seek help

You should encourage people to seek help if they have a fever and:

· are very hot, indicating a very high fever

· the fever continues for a long time

· the fever is accompanied by coughing and weight loss

· the fever is accompanied by symptoms such as stiff neck, severe pain, confusion, unconsciousness, yellow colour in the eyes, sudden severe diarrhoea or convulsions

· are pregnant or have recently had a baby

· live in an area where malaria is common and the fever has not gone away after one treatment with antimalarial medicine; discourage people from treating themselves repeatedly with such medicine.

Notes on fever