🦟 Children's Health

Under 5 — highest risk

Malaria in Children

Preventing and recognising malaria in your child — before it becomes severe.

Malaria kills thousands of Nigerian children every year — and most of these deaths are preventable. Children under 5 lack the partial immunity adults develop through repeated exposure, making them far more vulnerable to severe and fatal malaria. Rapid testing, prompt treatment, and prevention save lives.

⚠️ Go to Hospital IMMEDIATELY if your child has:

🚨 Child is unconscious, very difficult to wake, or confused — cerebral malaria

🚨 Convulsion (seizure) in a feverish child — immediate medical attention

🚨 Child is breathing very fast or with difficulty

🚨 Child cannot take any fluids by mouth or is vomiting everything

🚨 Extreme pallor — white inner eyelids, pale gums — severe anaemia

🚨 Child's belly is very swollen

🚨 No urine for 8+ hours despite drinking — possible kidney complications

🚨 Yellow eyes or very dark urine — blackwater fever

Signs Parents Notice

• High fever — often above 39°C

• Shivering and chills

• Crying and irritability

• Refusal to eat or drink

• Vomiting

• Headache (in older children who can report it)

• Diarrhoea — particularly in young children

• Pale inner eyelids — sign of anaemia from repeated infections

• Enlarged spleen — from repeated malaria (causes abdominal fullness)

Home Care — What You Can Do

Give paracetamol for fever

Paracetamol (dose by weight) to reduce fever and discomfort while seeking medical care. Do not delay going to test in order to wait and see if fever reduces.

Keep the child hydrated

Breast milk, water, or ORS while waiting for medical assessment. Small frequent sips if vomiting.

Get tested — do not treat without a positive test

Get a malaria RDT done before giving any antimalarial medication. A positive test confirms malaria and guides the right treatment.

When to Seek Medical Help

NowAny of the emergency signs above — and any fever in a child under 3 months old, regardless of suspected cause.

SoonFever in any child under 5 in Nigeria lasting more than 24 hours — malaria RDT and assessment are needed.

SoonA child who is being treated for malaria and is not improving in 24–48 hours — reassessment needed.

Common Mistakes to Avoid

🚫 Do not give chloroquine for malaria — Plasmodium falciparum (the main species in Lagos) is widely resistant
🚫 Do not treat for malaria without a positive test — this delays finding the real cause
🚫 Do not treat with herbal remedies instead of proven ACT medications
🚫 Do not wrap a feverish child in heavy clothing or blankets
🚫 Do not delay going to hospital if the child has emergency signs

Tests Your Doctor May Order

Malaria RDT

Quick finger-prick test — results in 15 minutes. Highly accurate. The first test for any febrile child in Nigeria.

Blood Film (Thick and Thin)

Microscopy — quantifies parasitaemia in severe malaria. Used in hospital setting for monitoring severe cases.

Full Blood Count

Assesses degree of anaemia from malaria — haemoglobin below 7 g/dL in a child requires transfusion consideration.

Blood Glucose

Hypoglycaemia (low blood sugar) is a common life-threatening complication of severe malaria in children — must be tested and corrected urgently.

How It Is Treated

Artemether/Lumefantrine (Coartem) — Uncomplicated Malaria

The WHO and Nigeria-recommended first-line treatment. Dosed by weight — 6 doses over 3 days. Must be given with food or milk for proper absorption. Complete all 6 doses even if the child seems better.

IV Artesunate — Severe Malaria (Hospital)

For severe malaria — injectable artesunate is the treatment of choice. Children should be admitted and monitored for complications (anaemia, hypoglycaemia, cerebral malaria).

Treating Complications

Blood transfusion for severe anaemia (Hb below 7 g/dL with symptoms), IV glucose for hypoglycaemia, anticonvulsants for prolonged seizures, oxygen for respiratory distress.

Prevention — Insecticide-Treated Bed Nets

Every child should sleep under an insecticide-treated bed net every night. This single measure reduces childhood malaria deaths by 20–30%.

Seasonal Malaria Chemoprevention (SMC)

Monthly sulfadoxine-pyrimethamine + amodiaquine for children aged 3–59 months in high-transmission seasons — available through government health programmes.

Frequently Asked Questions

How often should I give my child malaria treatment?

Only when a malaria test is positive. Repeated courses of antimalarials without testing is not appropriate. Frequent malaria in a child should prompt investigation for an underlying immune problem and consistent bed net use.

Can a child get malaria even with a bed net?

Bed nets reduce but do not eliminate malaria risk — particularly if the net has holes, is not treated, or the child spends evenings outside before the net is used. Combined with indoor spraying and other measures, protection is improved.

My child's malaria test was negative but the doctor wants to treat anyway — is that right?

A negative malaria RDT is highly reliable. Treating for malaria without a positive test delays diagnosis of the true cause. A blood film is a reasonable second step if clinical suspicion is very high. Request testing before treatment.

Is the malaria vaccine available for my child?

The R21 malaria vaccine is being rolled out in Nigeria. Contact your local Primary Health Centre or government immunisation clinic for current availability in your area.

My child gets malaria very frequently — why?

Frequent malaria may mean inadequate bed net use, high local mosquito exposure, or occasionally an underlying immune problem. Review bed net use carefully. If malaria is occurring monthly, discuss with your paediatrician.