The Fever Gap: Disparities in Febrile Seizure Management in Urban vs. Rural Pediatric Emergency Units

Abstract

Abstract:
Background: Febrile seizures (FS) are common, yet their management varies by facility resources. This study compares clinical protocols, diagnostic testing, and outcomes between rural and urban pediatric ERs.
Methods: Retrospective review of 682 children (6 months–5 years) presenting with FS across urban and rural hospitals in India (2021–2023). Investigations, treatments, hospitalization rates, and follow-up adherence were assessed.
Results: CT scans were more frequently performed in rural ERs (42.8% vs. 11.5%, p < 0.001) with no difference in intracranial findings. Hospitalization was higher in rural sites (29.2% vs. 17.8%, p = 0.02). Urban ERs had better adherence to follow-up (81% vs. 49%, p < 0.001).
Conclusion: Management of febrile seizures is influenced by setting and resource availability. Standardized guidelines and telemedicine access could reduce disparities and improve care.