The COVID-19 pandemic threatens to have significant indirect consequences for children in Sierra Leone, a country with a high malaria burden and some of the highest child mortality rates globally. In Kenema District, fears and rumours about COVID-19 lead fewer people to seek healthcare or to delay until conditions become more severe. The MSF Hangha hospital, which has been providing emergency care for children under 5 since March 2019, is seeing more children with serious and critical conditions. This is especially worrying with the malaria season approaching. Our projects in Kenema District are implementing adapted strategies to assure minimal disruption to malaria services including support for the Ministry of Health and Sanitation mass nets distribution, delivering healthcare in communities and door to door health promotion sensitizations, for both COVID-19 and non-COVID-19 pathologies.