Tonsillitis in African Children: Causes, Symptoms and Treatment


By: Favour Okere. BNSc. RN. Freelance Health Writer and Datelinehealth Africa (DLHA) volunteer. Medical review and editorial support provided by the DLHA Team

A black African mother taking a careful look at her baby son's head from the right side

A black African mother taking a careful look at her baby son's head from the right side


Key Facts

  • Tonsillitis is a highly common condition among African children.
  • It is a leading cause of missed school days and can significantly affect a child's well-being and school performance.
  • Most cases of tonsillitis are caused by infection with germs like a common virus being the most common in young children. Bacteria germs also may cause tonsillitis.
  • Signs and symptoms of tonsillitis include swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on the sides of the neck.
  • Early recognition and proper treatment are important to prevent potential complications and ensure a speedy recovery.




So, your little one has suddenly lost their appetite, their throat is sore, and they're burning with a fever. These could be signs of tonsillitis, a common childhood illness that repeatedly affects African children of all ages. 


Tonsillitis is a redness and soreness (inflammation) of the tonsils. It is a leading cause of missed school days and can significantly impact a child's well-being and school performance. In most studies conducted in Africa, it was found that tonsillitis affects about 12% to over 20% of children. [1, 2] 


If you suspect your child has tonsillitis, resist the urge to try unproven remedies or rush into drastic measures. Feeding them herbal concoctions or planning an immediate cutting of the tonsils could put your child's health at serious risk. Instead, arm yourself with the right knowledge and precautions, so you can conquer tonsillitis with ease and help your child feel better in no time.


What are Tonsils?


Tonsils are small, oval-shaped masses of lymphoid tissue located at the back of the throat, one on each side (See fig. 1) They are part of the body's immune system and act as the first line of defense against germs entering through the mouth or nose. While their primary function is to trap and fight off germs, they can sometimes become sore and red (inflamed), leading to tonsillitis.

Illustration of healthy and Inflammed tonsils in the back of mouth

Fig. 1: Illustration showing the location of the tonsils at the back of the throat. Note the difference in appearance (size and colour) between the healthy and inflamed tonsils. Click on image to enlarge 


Causes of Tonsillitis


Your child’s tonsillitis is caused by contact with germs (viral or bacterial). [3] The most common offenders are viruses (Epstein-Barr virus, Influenza, and Adenoviruses). Bacterial infections, such as those caused by Streptococcus pyogenes (group A streptococcus), are also responsible for a significant number of tonsillitis cases. 


Other factors that can increase your child’s risk of tonsillitis include:

  • Young age: Tonsillitis most often affects children. Those caused by viruses is common in children between age 2 - 5 years, [3] while bacteria causes is most common in children ages 5 to 15 and adults [2, 3]
  • Poor oral hygiene
  • Exposure to secondhand smoke
  • A weakened immune system.
  • Frequent exposure to germs. School-age children are in close contact with their school-mates and frequently exposed to viruses or bacteria that can cause tonsillitis.


Symptoms of Tonsillitis


Tonsillitis most commonly affects children from preschool ages to their mid-teen years. [4] Common signs and symptoms that your African child may have, include:

  • Sore throat and difficulty swallowing
  • Fever and chills
  • Swollen and reddened tonsils, sometimes with white or yellow patches
  • Painful upper neck swelling (due to lymph nodes)
  • Bad breath
  • Headache and body aches
  • Loss of appetite and fatigue
  • Neck pain or stiff neck
  • Drooling due to difficult or painful swallowing
  • Refusal to eat
  • Unusual fussiness


Diagnosis of Tonsillitis


Your doctor will typically diagnose tonsillitis based on a physical examination of your child's throat and tonsils. [5] In some cases, they may recommend a rapid strep test or throat culture.


To determine whether the tonsillitis is caused by a virus or bacteria, your doctor will consider several factors:

1. Your child's medical history

2. Clinical symptoms

3. Laboratory test results


These combined factors help differentiate between viral and bacterial tonsillitis, guiding appropriate treatment.


Treatment of Tonsillitis


The treatment of your child’s tonsillitis depends on the underlying cause. For viral tonsillitis, the focus is on managing symptoms, as the use of antibiotics to treat viral infections is ineffective and unnecessary. Such cases usually get better on their own in 4-5 days. To feel better, the doctor may recommend your child does the following:

  • Drinks lots of water
  • Takes kids pain relievers like ibuprofen or paracetamol. These are available for purchase at chemists without a doctor’s written order (prescription)
  • Uses throat lozenges or sprays
  • Gets plenty of rest


Bacterial tonsillitis, on the other hand, may require a course of antibiotics as specifically prescribed by your child's healthcare provider, to eliminate the infection and prevent potential complications like heart inflammation (rheumatic fever with heart inflammation) or kidney inflammation. [6]


Tonsillitis is contagious and can spread through close contact or when an infected person coughs or sneezes. To prevent its spreading, teach your child to wash their hands often and to avoid sharing drinks or food with others.


If your child gets tonsillitis too repeatedly, then your doctor might suggest removing their tonsils through surgery called a tonsillectomy. [7]


It is advisable to consult your doctor for a proper diagnosis and treatment plan. A doctor can determine the underlying cause, check the severity, and recommend the most appropriate course of action for the specific case of tonsillitis.


Remember, do not use antibiotics to treat your child with tonsillitis without recoomendation from their healthcare provider. Misuse and abuse of antibiotics cause germs (bacteria) to develop resistance to the drugs (i.e., Antimicrobial Resistance or AMR)


Prevention of Tonsillitis


While tonsillitis can be difficult to prevent entirely, there are several steps you can take to reduce your child’s risk:

  • Encourage good hand-washing habits in your child
  • Avoid sharing utensils, cups, or straws with others
  • Promote a balanced diet and adequate sleep to support a healthy immune system
  • Ensure your child is up-to-date on recommended vaccinations
  • Avoid overcrowded and improve household hygiene and living conditions to reduce the risk and spread of tonsillitis.




Tonsillitis is a common childhood ailment that can cause great discomfort for your little one. However, with early recognition, proper treatment, and preventive measures, you can help your child recover quickly and reduce the risk of future occurrences. 


Remember, seeking medical advice and following your doctor's recommendations are important for managing tonsillitis effectively. By being observant and seeking help early from your child’s healthcare provider, you can help ensure their wellbeing as they bounce back from a tonsil infection to their usual lively self in no time.



1. Is tonsillitis contagious?

A: Yes, both viral and bacterial tonsillitis can be contagious through respiratory droplets or direct contact with infected individuals.


2. When should I seek medical attention for my child's tonsillitis?

A: Seek prompt medical care if your child has difficulty breathing, swallowing, or is unable to take in fluids due to severe throat pain.


3. Are there long-term effects of tonsillitis?

A: While most cases of tonsillitis resolve without complications, recurrent or chronic tonsillitis may lead to consideration of a tonsillectomy (surgical removal of the tonsils) to prevent future infections.


4. Can tonsillitis go away on its own?

A: Yes. Viral tonsil infections can soon get better on their own. But when the tonsillitis is caused by a bacterial infection, it may require antibiotics to treat the infection and prevent any complications. It is advisable to see your doctor to determine the cause and appropriate line of treatment.



1. Haidara A, Sidibe Y, Samake D, Coulibaly A, Toure M, Coulibaly B, Soumaoro S, Guindo B, Diarra K, Coulibaly K, Sanogo B, Keita M, Mohamed A. Tonsillitis and Their Complications: Epidemiological, Clinical and Therapeutic Profiles. International Journal of Otolaryngology and Head & Neck Surgery, (2019) 8, 98-105. doi: 10.4236/ijohns.2019.83011. Available from here.

2. Alrayah M. The Prevalence and Management of Chronic Tonsillitis: Experience From Secondary Care Hospitals in Rabak City, Sudan. Cureus, vol. 15, no. 2, p. e34914. doi: 10.7759/cureus.34914. Available from here.

3. Anderson J, Paterek E. Tonsillitis. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Cited June 22, 2024. Available from here.

4. Robertson S. Tonsillitis Causes. News-Medical [Internet. Last updated 2023 Jan. 13], Cited June 22, 2024. Available from here.

5. Windfuhr JP, Toepfner N, Steffen, G. et al. Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management. Eur Arch Otorhinolaryngol 273, 973–987 (2016). doi: 10.1007/s00405-015-3872-6. Available from here.

6. Overview: Tonsillitis. [Internet Updated 2023 Jan. 21]. [Updated 2023 Jan 2]. Institute for Quality and Efficiency in Health Care (IQWiG); Cologne, Germany: 2006-. Available from here.

7. Vincent P. Tonsillitis. [Internet. Last updated 2024 June 25]. Patient Info. Cited June 29, 2024. Available from here.




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Published: June 30, 2024

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