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General Fever Management Protocol (WHO)

General

1. Assessment & Triage

Most fevers in primary care are due to self-limiting viral infections (like the common cold) rather than malaria or severe disease.

  • The "T3" Standard: Test. Treat. Track. Always test for Malaria (RDT) in endemic areas before prescribing antimalarials.
  • Identify the Source: Check for localized signs:
  • Cough/Runny Nose: Likely Acute Respiratory Infection (ARI).
  • Diarrhea: Likely Gastroenteritis.
  • Ear Pain: Possible Otitis Media.
  • Burning Urination: Possible Urinary Tract Infection (UTI).

    • 2. Management of Common Fevers

  • Viral/Nonspecific Fever: If no danger signs are present, avoid antibiotics. Treat with fluids and antipyretics (paracetamol) for comfort.
  • Acute Respiratory Infection (ARI): Most are viral. Antibiotics are not recommended unless there is fast breathing (suspected pneumonia).
  • Diarrhea: Treat primarily with Oral Rehydration Salts (ORS) and Zinc. Antibiotics are rarely needed unless there is blood in the stool.

    • 3. Key Principle

  • *Rational Use of Medicines: Do not treat "just in case." Withholding antimalarials and antibiotics in RDT-negative, stable patients is safe and reduces drug resistance.
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    Warning Signs

    GENERAL DANGER SIGNS (Refer Immediately)

  • Convulsions (current or history during illness).
  • Inability to drink or breastfeed.
  • Vomiting everything.
  • Lethargy or unconsciousness.
  • Stiff neck (Possible Meningitis).
  • Severe Respiratory Distress (Chest indrawing).

    • Reference

    1. World Health Organization (WHO) (2013). WHO Informal Consultation on Fever Management in Peripheral Health Care Settings: A Global Review of Evidence and Practice.
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