Ask any mother coming to her child‘s illness whether or not the child has fever; it is important that you assess all sick children for fever. A child has the main symptom of fever if the child has a history of fever or the child feels hot to touch or the child has an axillary temperature of 37.5°C or above.

Steps to assess fever

STEP 1. Ask and measure body temperature: Does the child have fever?.

Check if the child has a history of fever, feels hot or has a temperature of 37.5°C or above.

The child has a history of fever; is the child has had any fever with the current illness. Use words for "fever" that the mother understands. For example, ask the mother if the child‘s body has felt hot or use the local language that the mothers use to say fever.
Feel the child‘s body temperature whether the child is feeling hot or not around the abdomen and armpit or you can use a thermometer to measure the exact temperature.

If step 1 fulfils, you should assess the child following the next steps:

STEP 2. Decide malaria risk: high or low or no. If "low or no" malaria risk, then ask:

Has the child travelled outside this area during the previous 15 days?

If yes, has the child been to a malarious area?.

The practical criteria for the classification of risk of malaria in Ethiopia, where malaria is seasonal, should be based on altitude and season.

A. High-risk area: The altitude is less than 2,000 metres above sea level, especially during the months of September to December and from April to June.
B. Low-risk area: The altitude is between 2,000 – 2,500 metres above sea level, especially during the months of September to December and from April to June.
C. No risk area: The altitude is 2,500 metres above sea level.

If the malaria risk in the local area is low or absent, ask whether the child has a history of travel outside this area during the previous 15 days.

STEP 3. How long has the child had fever?.

If more than seven days, has the fever been present every day?.

Has the child had measles within the last three months?.

STEP 4. Do the Rapid Diagnostic Test (RDT) for malaria if available.

STEP 5. Ask the mother if the child has measles now or within the last three months.

STEP 6. Look and feel:

Look or feel for a stiff neck.
Look or feel for bulging fontanels (under one-year-old).
Look for a runny nose.
Look for signs of MEASLES.
Generalised rash and (one of these) cough, runny nose or red eyes.