Stop Treating Every Childhood Fever as Malaria, Paediatrician Warns Parents

 

By Atlantic Reports

A paediatrician at the Lagos University Teaching Hospital (LUTH), Dr Usman Ibrahim, has cautioned Nigerian parents against automatically treating children with fever, cough or runny nose for malaria without appropriate medical assessment and testing.

The warning comes amid concerns about the frequent misdiagnosis of childhood illnesses and the widespread practice of administering antimalarial medicines based on symptoms alone.

Ibrahim, a Senior Registrar in Paediatrics at LUTH, explained during an interview on Friday that many childhood respiratory infections are caused by viruses and may resolve without specific medication.

He noted that fever, although commonly associated with malaria in Nigeria, can also accompany the common cold and several other childhood illnesses.

The specialist warned that unnecessary antimalarial treatment could expose children to avoidable side effects, contribute to drug resistance and delay the identification of potentially serious medical conditions.

Why Parents Sometimes Confuse Common Cold With Malaria

According to Ibrahim, the common cold is a viral infection affecting the upper respiratory tract, particularly the nose and throat.

He identified coughing, a runny nose, frequent sneezing and nasal congestion as typical symptoms.

Children may also develop fever as their immune systems respond to the infection.

Because fever is also a common symptom of malaria, some parents may assume that any increase in a child's body temperature indicates a malaria infection.

However, Ibrahim explained that the presence of prominent respiratory symptoms, combined with an appropriately performed malaria test, could help healthcare professionals distinguish between the illnesses.

A negative result from a reliable malaria test makes malaria less likely, although clinicians may need to reassess a child if symptoms persist or clinical suspicion remains high.

The paediatrician stressed that malaria should not be diagnosed solely because a child has a fever.

Poor Laboratory Diagnosis Can Lead to Unnecessary Treatment

Ibrahim also expressed concern about the quality of malaria testing in some healthcare facilities.

He explained that certain laboratories lacked sufficient expertise in malaria microscopy, potentially contributing to inaccurate diagnoses and unnecessary treatment.

Malaria microscopy involves examining a blood sample under a microscope to identify malaria parasites.

When performed correctly, it can provide important information for diagnosis and treatment.

Rapid diagnostic tests are another recognised method of detecting malaria infection, although healthcare professionals must interpret results alongside a child's symptoms and medical condition.

Ibrahim observed that misconceptions about viral infections also contribute to inappropriate treatment.

Some parents, he explained, are unaware that children frequently experience viral illnesses that improve naturally with appropriate supportive care.

Others may believe that every episode of fever requires antibiotics or antimalarial medication.

Such assumptions can encourage unnecessary medicine use while overlooking the actual cause of a child's illness.

Unnecessary Antimalarial Drugs Carry Health Risks

The paediatrician warned that administering antimalarial medicines without confirming infection could have consequences beyond unnecessary expenditure.

Antimalarial medicines, like other medications, can cause adverse reactions and should be used according to appropriate medical guidance.

Inappropriate use also contributes to wider concerns about antimalarial drug resistance, which can undermine the effectiveness of treatments used against confirmed malaria infections.

Another important risk is delayed diagnosis.

When parents assume that fever is caused by malaria, they may overlook other conditions requiring different treatment.

These could include respiratory infections, ear infections or other illnesses that may need prompt medical assessment.

For children, particularly infants and those with underlying health conditions, delays in identifying serious infections can have significant consequences.

Ibrahim therefore urged parents to prioritise proper diagnosis rather than repeatedly administering medicines based on previous experiences or assumptions.

When Can a Child With Common Cold Be Managed at Home?

The paediatrician explained that many uncomplicated cases of the common cold can be managed at home with supportive care.

He said home management may be appropriate when a child is breathing comfortably, remains alert, eats and drinks satisfactorily and continues normal activities.

Adequate fluid intake is important because fever and illness can increase the risk of dehydration, particularly in younger children.

Paracetamol may also be used to relieve fever-related discomfort when appropriate for the child's age and weight, following professional guidance or approved dosing instructions.

Parents should avoid giving children medicines in excessive quantities or combining products containing the same active ingredient.

Other supportive measures, such as rest and keeping the child comfortable, may help during recovery.

However, fever in a baby younger than three months requires prompt medical assessment, even if the child otherwise appears well.

Parents should also avoid administering antibiotics or antimalarial medicines without appropriate medical advice.

Antibiotics do not treat the viruses responsible for the common cold.

Warning Signs That Require Immediate Medical Attention

Ibrahim identified several symptoms that should prompt parents to seek urgent medical care rather than continue home treatment.

These include:

• Fast or difficult breathing: A child breathing unusually rapidly, struggling to breathe or showing signs of respiratory distress requires urgent assessment.

• Repeated vomiting: Persistent vomiting can interfere with fluid intake and increase the risk of dehydration.

• Extreme weakness: Unusual tiredness, reduced responsiveness or difficulty waking a child may indicate serious illness.

• Convulsions: Any seizure requires immediate attention, particularly when it is a child's first seizure or is prolonged.

Other concerning signs include an inability to drink, blue or grey lips, and signs of significant dehydration.

The paediatrician emphasised that parents should not wait for symptoms to become severe before seeking professional help.

He encouraged families to visit healthcare facilities whenever they were uncertain or concerned about a child's condition.

Why Accurate Diagnosis Matters in Nigeria

In Nigeria, where malaria remains an important public health concern, fever in children often raises understandable anxiety among parents.

However, the fact that malaria is common does not mean every fever is caused by the disease.

Children may experience respiratory infections, gastrointestinal illnesses and other conditions that also produce fever.

Distinguishing these illnesses requires careful attention to symptoms, appropriate testing and clinical judgement.

For rural and underserved communities, access to reliable laboratory services and qualified healthcare professionals can present additional challenges.

Where diagnostic facilities are limited, families may resort to self-medication or purchase medicines directly from informal sources.

Improving access to accurate testing, strengthening healthcare workers' diagnostic skills and educating parents about common childhood illnesses could help reduce inappropriate treatment.

Parents Urged to Put Children's Safety First

Ibrahim's advice reinforces the importance of recognising that childhood fever is a symptom rather than a diagnosis.

Although the common cold usually improves with supportive care, malaria and other serious infections require timely identification and appropriate treatment.

The safest approach is therefore to assess the child's overall condition, obtain reliable testing when malaria is suspected and follow professional medical advice.

Parents should also understand that a child can have respiratory symptoms and malaria at the same time, making clinical assessment particularly important when illness is severe or persistent.

For families, the central message is that giving medicine quickly is not necessarily the same as providing the right treatment.

Ensuring that a child receives an accurate diagnosis can prevent unnecessary medication, reduce complications and support faster access to appropriate care.

As Ibrahim emphasised, parents should seek medical attention whenever they are worried about their children's health, even when symptoms initially appear mild.

Atlantic Reports: Voices. People. Facts.