FEVER MANAGEMENT IN CHILDREN. PARENTAL KNOWLEDGE AND PRACTICES

Abstract

Background: Fever is one of the most common reasons for pediatric healthcare visits. Although fever is usually a physiological response to infection, parental misconceptions may lead to inappropriate antipyretic use, unnecessary physical cooling, and inappropriate healthcare-seeking. Assessing parental knowledge and practices is therefore important for improving home management of febrile children. Objectives: To assess parental knowledge and practices regarding fever management in children and to identify selected factors associated with good parental knowledge. Methods: A hospital-based cross-sectional descriptive study was conducted at Al-Tuz General Hospital, Salah Al-Din Governorate, Iraq, under the Salah Al-Din Directorate of Health, from January 2025 to June 2026. The study included 278 parents or caregivers of febrile children. Data were collected using a structured questionnaire addressing sociodemographic characteristics, knowledge of fever, temperature measurement, antipyretic use, non-pharmacological measures, danger signs, and healthcare-seeking practices. Data were analyzed using the Statistical Package for the Social Sciences, and a P value <0.05 was considered statistically significant. Results: Mothers represented 78.4% of participants, 45.3% were aged 25–34 years, and 43.9% had college or higher education. Most children were aged 3–5 years (32.7%), and 86.0% of parents had previous experience with childhood fever. Overall, 46.4% of parents had good knowledge, 33.5% had moderate knowledge, and 20.1% had poor knowledge. Most parents recognized infection as a common cause of fever (80.6%) and the importance of fluid intake (85.3%). Paracetamol was the most commonly used antipyretic (88.5%). However, 27.7% used a household spoon for dosing, 24.8% alternated paracetamol and ibuprofen, and 44.6% used tepid sponging. Digital thermometers were used by 67.6%, while 24.1% relied on touch alone. Good knowledge was significantly associated with parental age (P=0.018), educational level (P<0.001), residence (P=0.006), and previous fever-management advice (P<0.001). In the estimated multivariable model, college or higher education (adjusted OR 2.74, 95% CI 1.61–4.66; P<0.001) and previous healthcare-professional advice (adjusted OR 2.31, 95% CI 1.42–3.76; P<0.001) remained independently associated with good knowledge. Conclusions: Important gaps remain in parental knowledge and fever-management practices despite relatively good awareness of some basic measures. Misconceptions concerning fever, medication dosing, alternating antipyretics, physical cooling, and temperature assessment were common. Structured and accessible parental education through pediatric and primary healthcare services is warranted.