Fever is one of the most common reasons for unwell children presenting to pharmacists and primary healthcare
practitioners. Currently there are no guidelines for assessment and management of fever specifically for community and primary healthcare workers in the sub-Saharan Africa region. This multidisciplinary consensus guide
was developed to assist pharmacists and primary healthcare workers in sub-Saharan Africa to risk stratify and
manage children who present with fever, decide when to refer, and how to advise parents and caregivers.
Fever is defined as body temperature ≥ 37.5 ◦C and is a normal physiological response to illness that facilitates
and accelerates recovery. Although it is often associated with self-limiting illness, it causes significant concern to
both parents and attending healthcare workers. Clinical signs may be used by pharmacy staff and primary
healthcare workers to determine level of distress and to distinguish between a child with fever who is at high risk
of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who
could be managed conservatively at home. In children with warning signs, serious causes of fever that may need
to be excluded include infections (including malaria), non-infective inflammatory conditions and malignancy.
Simple febrile convulsions are not in themselves harmful, and are not necessarily indicative of serious infection.
In the absence of illness requiring specific treatment, relief from distress is the primary indication for prescribing
pharmacotherapy, and antipyretics should not be administered with the sole intention of reducing body temperature. Care must be taken not to overdose medications and clear instructions should be given to parents/
caregivers on managing the child at home and when to seek further medical care.