# 6.3  Classifying fever

The next step after assessing for fever and measles is to classify the illness. If the child has fever and no signs of measles, classify the child for fever only. If the child has signs of both fever and measles, classify the child for both.

## Activity 6.1  Assess and classify fever (1)

This activity will help you to check your understanding of what you have learned so far. Make notes in your Study Diary in answer to the following questions:

• a.How would you classify a child with fever who lives in a low risk malaria area, and who does not have measles or a runny nose?
• b.If a child brought to your health post with fever has recently travelled to another area, but neither his mother nor you know the malaria risk for that area, how would you classify the child?
• c.What is the classification in all cases when a child has a fever and a stiff neck, bulging fontanelle or any general danger sign?

### Comment

As you may recall, the Assess and Classify chart has three tables for fever classification. One is for classifying fever when the risk of malaria is high; the second is for when the risk of malaria is low and the third is for classifying fever when there is no malaria risk.

Therefore, to classify fever, you must know if the malaria risk is high, low or none and then select the appropriate table.

For the child in question (a) above, you would use the ‘low risk’ table and classify for ‘malaria low risk’.

All children with fever and a stiff neck, bulging fontanelle or any general danger sign must be referred urgently.

The child in question (b) will need to be classified according to the high risk malaria table. You read that if you do not know the risk of malaria in an area a child has visited, you should assume ‘high risk’. Therefore this child should be classified as ‘malaria high risk’.

(c) In all cases where a child with fever also has a stiff neck, bulging fontanelle or any general danger sign, they must be classified as very severe febrile disease. In such cases you must refer the child urgently.

You will now look in more detail at how to classify malaria.

6.2.3  Assessing measles

6.3.1  Classification of malaria