A child with vomiting and fever can have anything from a mild viral infection to malaria or meningitis. Knowing when to manage at home and when to come in immediately is the most important thing a parent in Lagos can know. This page tells you exactly that.
Fever + vomiting in a child has a wide range of causes — from a viral illness that resolves in 2 days to malaria or meningitis that requires immediate treatment. The pattern, the child's behaviour, and the red flag signs guide the urgency.
The most common cause — vomiting + diarrhoea + mild fever, usually lasting 2–3 days. Self-limiting with oral rehydration. No antibiotics needed.
Fever, vomiting, headache, and malaise in a Lagos child should always have a malaria RDT. Falciparum malaria in children can deteriorate rapidly.
Often missed in children — fever + vomiting + irritability without diarrhoea, especially in young girls. Urine culture required.
Persistent fever (> 5 days), abdominal pain, vomiting — Salmonella typhi infection. Widal test and blood culture confirm.
High fever, vomiting, stiff neck, bulging fontanelle (in infants), photophobia, non-blanching rash — a medical emergency. Go to hospital immediately.
Fever, vomiting, and ear pain or pulling at the ear — common in children 1–5 years. Treatable with antibiotics.
Malaria RDT — First test for any child in Lagos with fever — See turnaround. If positive, antimalarial started immediately.
Full Blood Count — White cell count distinguishes bacterial from viral infection; identifies anaemia from malaria.
Urine Dipstick + Culture — Excludes UTI — especially important in girls and children without diarrhoea.
Widal Test (if fever > 5 days) — Screens for typhoid fever if fever is persistent and malaria is excluded.
Paracetamol syrup (15 mg/kg every 4–6 hours) for fever. Do NOT give aspirin to children under 16.
Give small, frequent amounts of fluid — ORS (oral rehydration salts) or water. Stop solid food until vomiting settles.
Monitor for the red flags above continuously. If any appear, go directly to a clinic or hospital.
Any child in Lagos with fever should have a malaria RDT — malaria in children can deteriorate within hours. The test takes 15 minutes.
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