title: Comparison of Infrared Thermal Detection Systems for mass fever screening in a tropical healthcare setting.
abstract: OBJECTIVE
  Fever screening systems, such as Infrared Thermal Detection Systems (ITDS), have been used for rapid identification of potential cases during respiratory disease outbreaks for public health management. ITDS detect a difference between the subject and ambient temperature, making deployment in hot climates more challenging. This study, conducted in Singapore, a tropical city, evaluates the accuracy of three different ITDS for fever detection compared with traditional oral thermometry and self-reporting in a clinical setting.
  
  
  METHODS
  This study is a prospective operational evaluation conducted in the Singapore military on all personnel seeking medical care at a high-volume primary healthcare centre over a one week period in February 2014.
  
  
  METHODS
  Three ITDS, the STE Infrared Fever Screening System (IFSS), the Omnisense Sentry MKIII and the handheld Quick Shot Infrared Thermoscope HT-F03B, were evaluated. Temperature measurements were taken outside the healthcare centre, under a sheltered walkway and compared to oral temperature. Subjects were asked if they had fever.
  
  
  RESULTS
  There were 430 subjects screened, of whom 34 participants (7.9%) had confirmed fever, determined by oral thermometer measurement. The handheld infrared thermoscope had a very low sensitivity (29.4%), but a high specificity (96.8%). The STE ITDS had a moderate sensitivity (44.1%), but a very high specificity (99.1%). Self-reported fevers showed good sensitivity (88.2%) and specificity (93.9%). The sensitivity of the Omnisense ITDS (89.7%) was the highest among the three methods with good specificity (92.0%).
  
  
  CONCLUSIONS
  The new generation Omnisense ITDS displayed a relatively high sensitivity and specificity for fever. Though it has a lower sensitivity, the old generation STE ITDS system showed a very high specificity. Self-reporting of fever was reliable. The handheld thermograph should not be used as a fever-screening tool under tropical conditions.
authors: Biodefence Centre, Singapore Armed Forces, 778910, Singapore.
authors: M R
authors: MR
authors: Tay
authors: Biodefence Centre, Singapore Armed Forces, 778910, Singapore.
authors: Y L
authors: YL
authors: Low
authors: Saw Swee Hock School of Public Health, National University of Singapore, 117597, Singapore.
authors: X
authors: X
authors: Zhao
authors: Saw Swee Hock School of Public Health, National University of Singapore, 117597, Singapore; Yale-NUS College, National University of Singapore, 138614, Singapore; Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, 169857, Singapore; Department of Statistics and Applied Probability, National University of Singapore, 138614, Singapore.
authors: A R
authors: AR
authors: Cook
authors: Biodefence Centre, Singapore Armed Forces, 778910, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, 117597, Singapore. Electronic address: vernonljm@hotmail.com.
authors: V J
authors: VJ
authors: Lee
mesh_terms: D001831:Body Temperature; D005260:Female; D005334:Fever / Q000175:diagnosis*; D006801:Humans; D007259:Infrared Rays; D008297:Male; D008403:Mass Screening / Q000295:instrumentation*; D008889:Military Personnel / Q000706:statistics & numerical data; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012846:Singapore; D014330:Tropical Medicine; D055815:Young Adult
keywords: Fever; Infrared; Mass screening; Thermometry; Tropical