For many Nigerian parents, a child with a cough, catarrh, or fever may not immediately trigger alarm. The first response is often familiar: reach for leftover antibiotic from a previous prescription, buy malaria medicine from a pharmacy, or wait for the symptoms to pass.
But health workers warn that what appears to be an ordinary childhood illness can sometimes signal a more serious respiratory infection and that treating every cough, fever, or sore throat the same way could do more harm than good.
‘Respiratory infections are not just mild infections. It is a leading cause of death in children under five,’ said Oluwasefunmi Oreoluwa Oladapo, brand manager, Pharma Symbiosis, on the sidelines of a training programme for health workers in Ibadan.
The training, organised in collaboration with the Oyo State Primary Healthcare Board, aimed to strengthen the capacity of frontline health workers to identify and manage respiratory infections.
Young children commonly experience respiratory illnesses, but symptoms that appear similar can have very different causes and require different treatment approaches.
Oladapo said that one of the key messages from the training was the need to distinguish between viral and bacterial respiratory infections.
The distinction is important because antibiotics work against bacteria, not viruses. Yet antibiotics are still commonly regarded as a quick solution for coughs, sore throats, and fever.
According to Oladapo, some viral respiratory infections may present with a runny nose, cough, low-grade fever, and body pains. Because these symptoms can overlap with other common illnesses, including malaria, individuals may be placed on several medicines without the underlying cause being properly established.
‘If a patient comes to you today with low-grade fever and all these other presentations, it is very easy to place the patient on malaria drugs and antibiotics because you have not clearly revealed and defined the symptoms,’ he said.
Bacterial infections, meanwhile, can present differently and may require antibiotic treatment. Health workers were trained to recognise clinical signs associated with bacterial tonsillopharyngitis and introduced to the Centor scoring tool, which can help clinicians assess patients presenting with acute sore throat.
In Nigeria, fever is often associated with malaria, while cough and catarrh are frequently treated as interchangeable signs of respiratory disease.
But assuming the cause without proper assessment can lead to inappropriate treatment and contribute to antimicrobial resistance, a condition in which bacteria become resistant to once-effective medicines.
As resistance increases, infections that were previously straightforward to treat can become more difficult, expensive, and potentially dangerous.
Oladapo said healthcare workers must recognise when antibiotics are indicated and, when necessary, select them appropriately.
He also warned mothers and other caregivers against treating children based on what worked during a previous illness.
‘A child who was prescribed an antibiotic during a previous infection may not need the same medicine the next time they develop a cough or fever. The new illness could have a different cause and therefore require a different treatment – or no antibiotic at all,’ he said.
Keeping and reusing leftover medicines without professional assessment can also contribute to inappropriate dosing and antimicrobial resistance.
‘The primary healthcare team is responsible for ensuring that your child is nursed back to health,’ Oladapo said.
Although not every cough requires a hospital visit, he urged parents to seek medical assessment when symptoms are persistent, severe, or unusual, instead of relying on previous prescriptions or advice from friends and relatives.
Treatment is only one part of protecting children from respiratory infections.
Oladapo urged parents to pay attention to hygiene and environmental conditions, particularly when children experience frequent infections.
Hand washing remains one practical measure that can help reduce the spread of infections. Children frequently touch surfaces, toys, and other objects before putting their hands near their mouths and faces.
Parents should therefore encourage regular hand washing, particularly before eating, after using the toilet, and after returning from outside environments.
Keeping living spaces clean and reducing exposure to conditions that may increase the spread of infection can also help protect vulnerable children.
However, when a child repeatedly becomes ill, parents should not simply assume that the problem is poor immunity and begin giving medicines or supplements without professional advice. Frequent or severe infections warrant proper medical assessment.
Oladapo said Pharma Symbiosis, an African multinational with a presence in more than 20 countries, sees primary healthcare as the closest point of contact between communities and the health system.
‘For a child with a cough, that early decision can make a difference. We believe that if you empower and strengthen the primary healthcare system, we can have healthier communities, healthier families and healthier Nigerians,’ he said.
That is why educating both health workers and caregivers matters.
Respiratory infections may begin with something as ordinary as a cough or runny nose. But the response should not be based on guesswork.
For Nigeria’s youngest children, the challenge is recognising when a seemingly simple illness may be something more serious – and ensuring that the right treatment reaches the child at the right time.