In this study, children with SCA and who took lime juice had less febrile illness and rates of hospitalization during the study period. In Nigeria, like most parts of sub-Saharan Africa, malaria infection is the leading cause of febrile illness, precipitant of bone pain crisis, and reason for hospitalization in children with SCA.12,13 Hence, efforts at curtailing malaria infection will significantly reduce morbidities in this group of children. A previous study6 has shown that lime juice enhances clearance of the malaria parasite when taken with appropriate antimalarial drugs. In that study,6 the average time to achieve more than 75% reduction in parasite load was significantly lower in patients on artemisinin combination therapy (ACT) and lime juice than those taking ACT alone. Also, a significantly higher proportion of children taking antimalarial drugs and lime juice achieved complete parasite clearance by 72 hours of therapy, and none developed early treatment failure. The pain in SCA is often triggered by dehydration, acidosis, and fever, which are usually brought about by malaria. Intake of lime juice, in addition to enhancing malaria parasite clearance, also improves hydration and alkalinizes the body.