For many Nigerian parents, a hot child means malaria. Sometimes it is. Sometimes the fever is caused by a cold, an ear infection, pneumonia or typhoid. Malaria in young children can be mild one day and life-threatening the next, so getting the diagnosis and treatment right matters. This guide explains the signs of malaria in children under five, why testing comes first, how to give medicine correctly and how to protect your child.
Why young children are at higher risk
Children under five have not yet built up partial immunity to malaria. Their bodies cannot control the parasites as well as older children and adults. As a result, malaria in young children can progress to severe malaria quickly, sometimes within a day. Most malaria deaths in Africa occur in children under five.
Babies under six months have some protection from their mothers, but they can still get malaria and need prompt care.
Common signs of malaria in young children
Children may not complain of the classic symptoms. Watch for:
Fever, or a hot body, sometimes coming and going
Irritability and crying more than usual
Poor feeding or refusing to breastfeed
Vomiting
Diarrhoea
Cough
Sleepiness or unusual tiredness
Chills or shivering
Pale skin
These signs overlap with many other childhood illnesses. A test is the only way to be sure.
Danger signs that need emergency care
Take your child to hospital immediately if they:
Have a fit or convulsion
Are very sleepy or difficult to wake
Cannot drink or breastfeed
Vomit everything
Have fast or difficult breathing
Have very pale palms or lips
Pass dark urine or very little urine
These are signs of severe malaria. They need injectable treatment in hospital.
Test before you treat
Every child with fever should be tested for malaria before treatment. A rapid diagnostic test from a finger or heel prick gives a result in about 15 to 20 minutes. Many pharmacies, clinics and primary health centres offer testing.
Testing matters because:
If the test is positive, your child gets the right medicine quickly.
If it is negative, the health worker can look for the real cause, such as pneumonia, which needs different treatment.
Giving antimalarials without a test can delay treatment for other serious illnesses.
Treatment for uncomplicated malaria
Dosing steps for treating malaria in young children with artemether-lumefantrine
Ask the pharmacist to weigh your child and confirm the dose.
Uncomplicated malaria in children is treated with an artemisinin-based combination therapy (ACT). The most common in Nigeria is artemether-lumefantrine1. Others include artesunate-amodiaquine and dihydroartemisinin-piperaquine.
Important points:
Dose by weight. Children’s doses depend on body weight. Ask the health worker to weigh your child.
Complete all doses. Artemether-lumefantrine is given twice a day for three days, six doses in total. Do not stop when the fever goes.
Give with food or milk. Lumefantrine is absorbed better with a little fatty food or breast milk.
Use child-friendly forms. Dispersible tablets dissolve in a little water and are easier for young children.
If your child vomits a dose
If your child vomits within 30 minutes of a dose, give the same dose again. If they vomit again, or cannot keep medicine down, take them to a health facility. Repeated vomiting can be a sign of severe malaria and means the medicine is not being absorbed.
HUBPHARM PHARMACIST’S NOTE
Getting the dose right for a small child is the most common worry we hear. Splitting adult tablets or guessing doses leads to treatment failure. Message a HubPharm pharmacist with your child’s weight and age. We will confirm the correct dispersible ACT, show you how to dissolve and give each dose, explain what to do if your child vomits and give you a simple six-dose checklist. We also supply paracetamol syrup, test kits and treated nets for the whole family.
Managing fever at home
Alongside antimalarial treatment:
Give paracetamol at the right dose2 for your child’s age or weight to bring down fever
Dress your child in light clothing
Sponge with lukewarm water, not cold water
Offer plenty of fluids and continue breastfeeding
Offer small, frequent meals
Never give aspirin to children. Avoid putting children in cold water or using alcohol rubs.
Malaria in young children under six months
Young babies can get malaria, especially if their mothers had malaria during pregnancy or live in high-transmission areas. Signs may be subtle: poor feeding, unusual sleepiness, fever, irritability or jaundice. Any baby under two months with fever needs urgent assessment, whatever the cause. Doses of antimalarials for small babies must be calculated carefully by a health worker.
Malaria and other illnesses together
Children can have malaria and another illness at the same time, such as pneumonia or a urinary infection. If your child has a cough, fast breathing, diarrhoea or ear pain alongside a positive malaria test, the health worker should check for these too. Treating malaria alone may not be enough.
When to return
Return to the health worker if:
The fever does not improve after two days of treatment
Your child gets worse at any time
Any danger sign appears
Fever comes back within a few weeks of treatment
A fever that continues may mean the medicine was not effective, the dose was wrong or the illness is something other than malaria.
Malaria in young children and anaemia
Repeated malaria infections destroy red blood cells and can cause anaemia. Children with anaemia may be pale, tired and breathless. Severe anaemia is dangerous and may need a blood transfusion. Iron-rich foods, such as beans, green vegetables, eggs and meat, help recovery. Your health worker may also prescribe iron or other supplements.
Taking care of the net
A torn or poorly hung net gives little protection. Tuck the edges under the mattress or mat every night. Repair holes with thread or tape. Wash the net gently with mild soap, no more than a few times a year, and dry it in the shade. Make sure young children sleep under the net from early evening, when mosquitoes start biting. These habits greatly reduce malaria in young children.
Talking to your child’s caregivers
Nannies, grandparents and day-care staff often look after young children. Make sure they know the danger signs and where the nearest health facility is. Leave your phone number and agree on what they should do if your child develops a fever while you are away. Everyone caring for your child plays a part in preventing malaria in young children from becoming severe.
Preventing malaria in young children
Prevention is the best protection:
Sleep under an insecticide-treated net3 every night, all year round
Seasonal malaria chemoprevention (SMC) in eligible areas, given monthly during the rainy season to children aged 3 to 59 months
Malaria vaccine, being introduced in parts of Nigeria for young children
Clear stagnant water around the home
Screen windows and doors where possible
Long sleeves in the evening for older babies and toddlers
Myths about malaria in young children
“Every fever is malaria.” Many fevers have other causes. Test first.
“Herbal baths cure malaria.” Herbal baths do not kill malaria parasites. Use proven medicines.
“You can stop medicine once the fever goes.” Stopping early can let malaria return and lead to resistance.
“A strong injection works faster for children.” Injections are for severe malaria in hospital, not for routine cases.
Keep a fever record
Write down the time and temperature each time your child has a fever, the medicines given and the doses. Bring the record to the health worker. It helps them decide quickly whether treatment is working.
Ask before giving any medicine
Always tell the pharmacist your child’s age and weight before buying any medicine for fever, cough or diarrhoea.
Twice a day for three days, six doses. Give with milk or food.
2
Paracetamol syrup
Over the counter
For fever and discomfort at the right dose for age or weight.
3
Insecticide-treated net
Free in campaigns, also sold
Every night, all year round.
To order any of these, or to ask a pharmacist a question first, message HubPharm on WhatsApp or visit hubpharmafrica.com. Prescription medicines are supplied against a valid prescription.
Malaria and Typhoid Fever: How to Tell Them Apart… "You have malaria and typhoid." It is one of the most common diagnoses given in Nigeria, and millions of people are treated for both at the same time. Yet malaria and typhoid fever are two…
Ghana ENT Nurses Seek Inclusion in Free Primary… KOFORIDUA, GHANA — Ear, nose and throat (ENT) nurses in Ghana have called on the government to include them in its free primary healthcare policy, saying millions of people lack timely ear and hearing care…
Respiratory Challenges: A Comprehensive Guide to… Respiratory infections are a common health concern, affecting millions of people worldwide each year. Among the various respiratory infections, pneumonia and bronchitis stand out as significant contributors to global morbidity and mortality rates. These conditions…
Lassa Fever Warning Signs: Early Action Saves Lives Lassa fever is a viral illness that is found in West Africa, and Nigeria reports more cases than any other country. Each year, outbreaks peak during the dry season, from about December to April. In…
