Children get sick often — not because something is wrong, but because their immune systems are still learning. Every infection a child's body fights is a lesson: the immune system remembers the pathogen and destroys it faster next time. But some illnesses are serious, and knowing which ones can wait and which ones need immediate attention can genuinely save a child's life. This article covers the most common and important illnesses affecting children in Ghana and across Africa.

Why Children Get Sick More Often

A child's immune system is not fully developed at birth. It takes years of exposure to viruses, bacteria, and other pathogens to build the library of antibodies and memory cells that give adults their relative resistance to common infections.

Children also spend time in close contact with other children — in schools, churches, and play groups — which makes transmission of infections almost inevitable. The average child has 6 to 8 respiratory infections per year. This is normal and even necessary for healthy immune development.

The concern is not frequency — it is severity. Most childhood illnesses are mild and self-limiting. A small number can become life-threatening if not recognised and treated promptly.

Malaria

The Deadliest Childhood Disease in Sub-Saharan Africa

Malaria kills a child in Africa every two minutes. It is caused by Plasmodium parasites — most commonly Plasmodium falciparum in Ghana — transmitted by the bite of infected female Anopheles mosquitoes, which bite predominantly at night.

When the parasite enters the bloodstream, it travels to the liver where it multiplies. It then invades red blood cells, destroying them in cycles — causing the characteristic pattern of fever, chills, and sweating that comes in waves every 48 to 72 hours.

Symptoms — Act Quickly

  • High fever — often the first sign, may come with shaking chills
  • Headache and body aches
  • Vomiting and loss of appetite
  • Pale appearance — anaemia from red blood cell destruction
  • Fatigue and weakness

Danger signs requiring emergency care: Convulsions, inability to drink or breastfeed, vomiting everything, unconsciousness or abnormal drowsiness, very fast breathing, yellowing of the eyes (jaundice). These indicate severe malaria — a medical emergency with high mortality if untreated.

Treatment and Prevention

  • Test before treating — a rapid diagnostic test (RDT) or blood smear confirms malaria. Never treat without confirmation if possible.
  • First-line treatment in Ghana: Artemisinin-based Combination Therapy (ACT) — specifically artesunate-amodiaquine or artemether-lumefantrine. Complete the full course even if the child feels better.
  • Severe malaria: Injectable artesunate in hospital — do not delay
  • Prevention: Sleep under insecticide-treated bed nets (ITNs) every night — this single intervention reduces child malaria deaths by up to 50%. Remove standing water around the home. Use insecticide sprays in sleeping areas.
  • Malaria vaccine (R21/Matrix-M): Now recommended by WHO and being rolled out in Ghana — significant milestone in malaria prevention

Diarrhoeal Diseases

Diarrhoea — passing three or more loose or watery stools per day — is the second leading cause of death in children under five worldwide. It kills about 525,000 children every year, mostly through dehydration.

Common causes in children:

  • Rotavirus — the most common cause of severe diarrhoea in young children globally; causes watery diarrhoea, vomiting, and fever
  • Bacteria — E. coli, Salmonella, Shigella (causes bloody diarrhoea — known as dysentery)
  • Cholera — produces profuse, watery "rice water" diarrhoea; can kill within hours through dehydration
  • Parasites — Giardia, Cryptosporidium, usually from contaminated water

Signs of Dangerous Dehydration

  • Sunken eyes
  • Dry mouth and tongue
  • No tears when crying
  • Skin that stays pinched when you pull it (reduced skin turgor)
  • Sunken fontanelle (soft spot on top of a baby's head)
  • Reduced or no urination — nappies staying dry
  • Extreme weakness or drowsiness

Any of these signs mean the child needs immediate medical attention. Severe dehydration in an infant can cause organ failure and death within hours.

Treatment — ORS Saves Lives

Oral Rehydration Solution (ORS) is one of the greatest public health achievements in history. It is a precise mixture of sugar, salt, and water that the gut can absorb even during active diarrhoea. Widely available in pharmacies and health facilities across Ghana.

  • Give ORS in small sips frequently — not in large amounts at once
  • Continue feeding — food does not worsen diarrhoea and helps recovery
  • Breastfeeding should continue throughout
  • Zinc supplementation (10–20mg daily for 10–14 days) reduces duration and severity and decreases recurrence for weeks after the illness
  • Antibiotics are only needed for bloody diarrhoea (Shigella), cholera, or confirmed bacterial infection — not for watery diarrhoea
  • Do NOT give anti-diarrhoeal medications like loperamide to children — dangerous in paediatric diarrhoea

Prevention: Handwashing with soap after toileting and before food. Safe drinking water — boil if uncertain. Exclusive breastfeeding for the first 6 months. Rotavirus vaccination.

Pneumonia

Pneumonia is an infection of the lungs in which the tiny air sacs (alveoli) fill with pus or fluid, making breathing difficult. It is the single largest infectious cause of death in children under five worldwide — killing about 740,000 children every year.

Common causes:

  • Bacteria — Streptococcus pneumoniae (pneumococcus) is the leading bacterial cause; also Haemophilus influenzae type b (Hib)
  • Viruses — RSV (Respiratory Syncytial Virus) is the leading cause in infants under 1; also influenza, parainfluenza
  • In newborns: Group B Streptococcus and other bacteria acquired during birth

Symptoms and Danger Signs

  • Cough — may be with or without phlegm
  • Fever
  • Fast breathing — the most reliable sign of pneumonia in children. More than 60 breaths per minute in infants under 2 months; more than 50 in infants 2–12 months; more than 40 in children 1–5 years
  • Chest indrawing — the lower chest pulls in with each breath, indicating the lungs are working very hard. This is a sign of severe pneumonia.
  • Grunting sounds with each breath
  • Bluish tinge around the lips (cyanosis) — emergency sign
  • Inability to drink or breastfeed

Count breathing for a full minute when the child is calm. Fast breathing is the most important early warning sign of pneumonia.

Treatment

  • Mild pneumonia (fast breathing only): Oral amoxicillin for 5 days — can often be treated at home
  • Severe pneumonia (chest indrawing, danger signs): Hospital admission, injectable antibiotics (ampicillin plus gentamicin or benzylpenicillin), oxygen if oxygen saturation is below 90%
  • Viral pneumonia: No antibiotics needed unless secondary bacterial infection is suspected; supportive care only
  • Nutrition — malnourished children have much higher mortality from pneumonia; nutritional support is part of treatment

Prevention: Pneumococcal vaccine (PCV13) — in Ghana's EPI schedule. Hib vaccine. Measles vaccine (measles can lead to severe pneumonia). Exclusive breastfeeding. Avoid smoke exposure — both indoor cooking smoke and tobacco smoke significantly increase pneumonia risk.

Ear Infections (Otitis Media)

Ear infections are one of the most common reasons parents bring young children to the doctor. The middle ear — the space behind the eardrum — becomes infected, usually following a cold or respiratory infection.

Children are particularly prone because their Eustachian tube — the small tube connecting the middle ear to the back of the throat — is shorter, more horizontal, and floppier than in adults. This makes it easier for bacteria and viruses to travel from the throat up to the ear.

Most ear infections in young children are caused by the same bacteria that cause pneumonia — Streptococcus pneumoniae and Haemophilus influenzae.

Symptoms

  • Ear pain — older children tell you; infants tug or pull at the ear, are unusually irritable, cry more than normal
  • Fever
  • Difficulty sleeping — lying down increases ear pressure and worsens pain
  • Reduced hearing or not responding normally to sounds
  • Fluid draining from the ear — means the eardrum has perforated (burst). This sounds alarming but actually relieves the pressure and pain. The eardrum heals on its own in most cases.

Treatment

  • Pain relief first — paracetamol or ibuprofen relieves pain and fever. This matters even while awaiting further assessment.
  • Most ear infections resolve without antibiotics — about 80% clear up on their own within a few days in children over 2 years
  • Antibiotics are recommended for children under 2, those with severe symptoms, those with infections in both ears, or those who are not improving after 48–72 hours. Amoxicillin is first choice.
  • Recurrent ear infections may need specialist review — can cause hearing loss and speech delays if untreated

Prevention: Breastfeeding reduces ear infection risk significantly. Pneumococcal and influenza vaccines reduce infections. Avoid smoke exposure. Do not prop bottles — feeding a baby lying flat increases fluid entry into the Eustachian tube.

Fever — When to Worry and When Not To

Fever (temperature above 37.5°C or 99.5°F) is one of the most common reasons parents seek medical attention. It is important to understand what fever is and is not.

Fever is not a disease. It is the body's response to infection — raising body temperature makes it harder for many pathogens to survive and stimulates immune function. A fever itself rarely causes harm.

Seek Immediate Medical Attention If

  • The child is under 3 months old with any fever — always a medical emergency at this age
  • Fever above 39°C in a child under 6 months
  • Fever lasting more than 3 days in any child
  • Convulsions (febrile seizures) — lay the child on their side, do not put anything in the mouth, go to hospital
  • The child has a rash alongside fever
  • The child is unusually difficult to wake, very limp, or unresponsive
  • The child cannot drink any fluids
  • The child has a stiff neck (meningitis sign)

Most childhood illnesses are not dangerous — but the ones that are can deteriorate quickly. The most important skill a parent can develop is knowing the warning signs that say "this child needs a doctor now." Fast breathing in a sick child. Signs of dehydration. Unusual drowsiness. A rash with fever. These are the signals that should never be waited out at home. When in doubt, seek care. A doctor would rather see a well child than miss a sick one.