Introduction

It is 2 AM. Your child is burning up. Their body is hot to the touch, they are restless, and you are frightened. Do you rush to the hospital right now? Do you give paracetamol and wait until morning? Do you sponge them down?

Every parent in Nigeria has faced this moment, and very few feel fully confident about what to do.

Fever is one of the most common reasons parents bring children to pharmacies and hospitals in Nigeria. It is also one of the most misunderstood.

This guide is designed to give you clear, practical, evidence-based information so that the next time your child has a fever, you know exactly what to do, when to act, and when it is safe to wait.

What is a Fever?

A fever is a temporary rise in body temperature, usually in response to an infection. It is not a disease itself — it is a sign that the body's immune system is working.

Normal body temperature in children is approximately 36.5 to 37.5°C.

• Fever: 38°C or higher
• High fever: above 39°C
• Very high fever: above 40°C (urgent attention required)

Contrary to what many parents believe, the height of the fever does not reliably tell you how serious the illness is.

A child with 40°C from a viral infection may still look relatively well.

A child with 38.5°C from a serious infection may look very unwell.

What matters most is how your child looks, behaves, and responds to you.

What Causes Fever in Children?

Most fevers in Nigerian children are caused by infections — and most are viral and resolve on their own.

Common causes include:

• Malaria — very common in northern Nigeria
• Viral infections — colds, flu, throat infections
• Typhoid fever
• Ear infections
• Urinary tract infections
• Tonsillitis
• Chicken pox and other viral illnesses
• After vaccinations — mild fever is common within 24–48 hours after many vaccines, and can occur later (about 1–2 weeks) after certain vaccines such as measles-containing vaccines

How to Measure a Child’s Temperature Correctly

Accurate measurement is essential.

Recommended methods:

• Rectal thermometer — most accurate for infants under 3 months
• Oral thermometer — for children over 4 years
• Armpit (axillary) — less accurate (add ~0.5°C)
• Ear thermometer — for children over 6 months
• Forehead thermometer — convenient but less reliable

Avoid using your hand — it is unreliable.

Digital thermometers are affordable and available at Amkamed Pharmaceuticals.

When to Wait and Manage at Home

You can safely manage your child at home if ALL of the following are true:

• Child is over 3 months old
• Temperature is below 39°C
• Child is alert and interacting normally
• Child is drinking fluids
• No serious symptoms (breathing difficulty, rash, stiff neck)
• Fever present for less than 3 days

Home Management Steps

• Give paracetamol at 10–15 mg per kg of body weight per dose (ask your pharmacist if unsure)
• Ibuprofen can be used in children over 6 months (usually 10 mg/kg per dose)
• Never give aspirin to children
• Dress the child lightly
• Encourage fluids continuously
• You may use lukewarm sponging, but it is optional. Some children become uncomfortable or start shivering, which can make them feel worse. Medication alone is often enough.
• Monitor temperature every 2–4 hours

When to Go to Hospital Immediately

Seek urgent care if:

• Baby under 3 months has any fever
• Age 3–6 months with temperature ≥38.5°C
• Temperature ≥40°C at any age
• Fever lasts more than 3 days
• Convulsions (fits)
• Child is difficult to wake, limp, or unresponsive
• Rash that does not fade when pressed
• Stiff neck or severe headache
• Difficulty breathing
• Signs of dehydration
• You feel something is seriously wrong

Febrile Convulsions: What to Do

Febrile convulsions occur in 2–5% of children (6 months–6 years).

If it happens:

• Stay calm
• Lay the child on their side
• Do NOT put anything in the mouth
• Do NOT restrain movement
• Time the convulsion
• Go to hospital immediately

If it lasts more than 5 minutes → emergency

Common Mistakes Parents Make

• Giving adult medications to children
• Overdosing paracetamol
• Using cold water or ice
• Giving antibiotics unnecessarily
• Delaying medical care
• Mixing medications without advice

Malaria and Fever: A Special Note

In northern Nigeria, malaria is a common cause of fever.

Suspect malaria if:

• Fever comes in cycles
• Child has chills
• Recent mosquito exposure
• Rainy season

A Rapid Diagnostic Test (RDT) can confirm malaria.

At Amkamed Pharmaceuticals, we strongly advise:

Test before treating.

Conclusion

Fever in children is very common — and in most cases, it is not dangerous.

What matters most is not the number on the thermometer, but how your child looks and behaves.

With the right knowledge, you can stay calm, act appropriately, and protect your child.

At Amkamed Pharmaceuticals, Gombe State, we are always here to support you — from correct dosing to malaria testing and guidance on when to seek care.

Worried about your child’s fever?

Visit Amkamed Pharmaceuticals, Gombe State for trusted advice and safe treatment.

amkamed.com

References

ACR Appropriateness Criteria® Fever Without Source or Unknown Origin-Child: 2024 Update.Journal of the American College of Radiology : JACR. 2025. Cooper ML, Iyer RS, Chan SS, et al.NewGuideline

Clinical Practice Guideline: The Outpatient Management of Fever in Children and Adolescents.Deutsches Arzteblatt International. 2026. Niehues T, Krafft H, Schemmer J, et al.New

Clinical Policy for Well-Appearing Infants and Children Younger Than 2 Years of Age Presenting to the Emergency Department With Fever.Annals of Emergency Medicine. 2016. Mace SE, Gemme SR, Valente JH, et al.Guideline

Acute Febrile Illness in Kenya: Clinical Characteristics and Pathogens Detected Among Patients Hospitalized With Fever, 2017-2019.PloS One. 2024. Verani JR, Eno EN, Hunsperger EA, et al.

Beyond Malaria — Causes of Fever in Outpatient Tanzanian Children.The New England Journal of Medicine. 2014. D'Acremont V, Kilowoko M, Kyungu E, et al.

Etiology and Clinical Characteristics of Pediatric Acute Fever Among Hospitalized Children in an Endemic Malaria Transmission Area of Cameroon in Central Africa.PloS One. 2023. Penda CI, Épée Eboumbou P, Ngondi G, et al.

Bacteraemia, Malaria, and Case Fatality Among Children Hospitalized With Fever in Dar Es Salaam, Tanzania.Frontiers in Microbiology. 2020. Moyo SJ, Manyahi J, Blomberg B, et al.

Management of Fever in Infants and Young Children.American Family Physician. 2020. Hamilton JL, Evans SG, Bakshi M.

Clinical Signs Associated With Mortality and Sepsis in Young Infants.JAMA Pediatrics. 2026. Driker S, Mathias S, Fung A, et al.New

Prophylactic Drug Management for Febrile Seizures in Children.The Cochrane Database of Systematic Reviews. 2021. Offringa M, Newton R, Nevitt SJ, Vraka K.

Febrile Seizures: Risks, Evaluation, and Prognosis.American Family Physician. 2019. Smith DK, Sadler KP, Benedum M.

Epilepsy in Children.Lancet. 2006. Guerrini R.

Febrile Seizures: A Systematic Review of Different Guidelines.Pediatric Neurology. 2024. Corsello A, Marangoni MB, Macchi M, et al.

Management of Pediatric Febrile Seizures.International Journal of Environmental Research and Public Health. 2018. Laino D, Mencaroni E, Esposito S.

Febrile Seizures: Risks, Evaluation, and Prognosis.American Family Physician. 2012. Graves RC, Oehler K, Tingle LE.

Comparison of Acetaminophen (Paracetamol) With Ibuprofen for Treatment of Fever or Pain in Children Younger Than 2 Years: A Systematic Review and Meta-analysis.JAMA Network Open. 2020. Tan E, Braithwaite I, McKinlay CJD, Dalziel SR.

Acetaminophen and Ibuprofen in the Treatment of Pediatric Fever: A Narrative Review.Current Medical Research and Opinion. 2021. Paul IM, Walson PD.

Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management.Pain and Therapy. 2015. de Martino M, Chiarugi A.

Effectiveness and Safety of Interventions for Fever-Associated Discomfort in Children: A Systematic Review.British Journal of Clinical Pharmacology. 2025. Corsello A, Alberti I, Farhanghi S, et al.New

Physical Methods for Treating Fever in Children.The Cochrane Database of Systematic Reviews. 2003. Meremikwu M, Oyo-Ita A.

External Cooling in the Management of Fever.Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2000. Axelrod P.