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World J Clin Cases. Nov 16, 2025; 13(32): 110760
Published online Nov 16, 2025. doi: 10.12998/wjcc.v13.i32.110760
Fever phobias, perception among caregivers across Nigerian states: A systematic review and meta-analysis
Awoere Chinawa, Paschal Chime, Jude Onyia, Grace Agu, Ogonna Nwankwo, Josephat Maduabuchi Chinawa
Awoere Chinawa, Department of Community Medicine, Enugu State Univeristy College of Medicine, Enugu 400001, Nigeria
Paschal Chime, Department of Pediatrics, University of Nigeria, Ituku-Ozalla, Enugu 400001, Nigeria
Jude Onyia, Grace Agu, Department of Pediatrics, University of Nigeria Teaching Hospital, Enugu 400001, Nigeria
Ogonna Nwankwo, Department of Pediatrics, Enugu State Univeristy College of Medicine, Enugu 400001, Nigeria
Josephat Maduabuchi Chinawa, Department of Paediatrics, University of Nigeria, Nsukka 400001, Nigeria
Co-corresponding authors: Paschal Chime and Josephat Maduabuchi Chinawa.
Author contributions: Chinawa JM conceived and designed this study performed the data analysis/interpretation; Chinawa JM, Chinawa A, Chime P, Onyia J, Agu G and Nwankwo O helped in the critical revision of the article.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Josephat Maduabuchi Chinawa, FACC, Professor, Department of Paediatrics, University of Nigeria, 1o Thinkers estate Enugu, Nsukka 400001, Enugu, Nigeria. josephat.chinawa@unn.edu.ng
Received: June 16, 2025
Revised: June 20, 2025
Accepted: October 14, 2025
Published online: November 16, 2025
Processing time: 151 Days and 21.4 Hours
Abstract
BACKGROUND

There is a need to synthesize the different patterns of fever treatment and phobias in Nigeria and to document these behavioral issues among caregivers. Although, fever is commonly seen in children and this make the mothers to seek medical care when all effort of theirs have failed. Yet, this behavioral and anxiety disorders among mothers still persists several years after the word “Fever phobia” was coined.

AIM

To document the knowledge of fever among Nigerian mothers and to determine heterogeneity in these practices across the nation.

METHODS

A search of articles on fever phobias among mothers or caregivers in Nigeria was performed via the Cochrane Database of Systematic Reviews, PubMed, Google Scholar, and MEDLINE. Articles published between 2008, and 2023 were included in the study. The keywords used in the literature search included fever, phobias, perceptions, mothers, caregivers, perceptions, drugs, knowledge, and practices. Boolean operators were also used in the search for items, such as “fever AND phobia”, “fever AND perception”, “fever AND mothers”, “fevers AND/OR phobia”, “AND OR mothers/caregivers”, to help narrow parameters in the search engine and enhance reproducibility. Studies that fulfilled the inclusion criteria were presented via the PRISMA model. I2 statistics were used to assess heterogeneity.

RESULTS

The studies show wide variation in the reported levels of knowledge about fever, with proportions ranging from as low as 35% to as high as 94%. The pooled proportion estimate using the common effect model is 65% (95%CI: 64%-67%), assuming that all studies reflect a single underlying value. However, the random effects model, which accounts for differences among studies, yields a higher estimate of 70% (95%CI: 56%-82%). This divergence reflects significant heterogeneity in the data, with a Tau² of 0.7007, I² of 95.7%, and, an H statistic of 4.80, all indicating that most of the variability is due to actual differences among studies rather than random chance. The Q test further confirms this, with a P value less than 0.0001, reinforcing that the variability across studies is statistically significant. The subgroup analysis revealed that studies in Group A (six studies) reported a pooled knowledge proportion of 75%, with a confidence interval ranging from 56% to 88%, and relatively lower heterogeneity (Tau² = 0.5709, Tau = 0.7556), indicating greater consistency in their findings. In contrast, Group B (four studies) had a lower pooled estimate of 62%, but with a much wider confidence interval (27% to 88%) and greater heterogeneity (Tau² = 0.8380, Tau = 0.9154), suggesting greater variation across studies in that group. Fear of brain damage, convulsions, witches/wizards, and death was high in many of the studies. Herbal concoctions, and prayers were the mostly used measures to cure fever by mothers.

CONCLUSION

Mothers’ knowledge of fever detection in children is low. There was heterogeneity in the sample size of the studies, which may have affected the knowledge of fever.

Keywords: Fever; Phobia; Heterogeneity; Children; Mothers; Meta-analysis

Core Tip: In Nigeria, childhood fevers are often mistaken as malaria and this had led to majority of deaths among under-five children. Similarly, fever as a result of vaccination of childhood killer diseases accounts for over 30% of all presenting complaints to children hospital. Regrettably, caregivers still consider childhood fever as a disease and not as a sign of an underlying disease. This makes them to indulge in unacceptable practices. Fever phobias is a global issue among caregivers and goes beyond cultures, race and language.