Gambia's government is investigating whether the deaths of dozens of young children from kidney failure are linked to a paracetamol syrup.

A spike in cases of acute kidney injury among children under the age of five was detected in late July. As cases mounted, doctors began to suspect medicines could be involved.

Gambia's director of health services, Mustapha Bittaye, told Reuters on Thursday a number of patients began to fall ill with kidney problems three to five days after taking a paracetamol syrup sold locally.

It is not known if a particular brand of paracetamol is under investigation.

E. coli bacteria was also a possible cause, Bittaye said.

Symptoms suffered by the children included an inability to pass urine and a fever that could end in kidney failure within hours.

By early August, 28 children had died, according to health ministry figures, for a fatality rate of almost 90 per cent.

Bittaye said the number of fatalities is now much higher.

"Dozens of children have died in the last three months," he told Reuters by phone. "Autopsies suggest the possibility of paracetamol."

In a statement last week, health authorities said that this kind of illness often has more than one cause.

E. coli bacteria could also be a possible cause as heavy rains have caused flooding in Gambia, and across much of West Africa, in recent weeks. The unpaved streets of the capital Banjul and surrounding towns have been overwhelmed.

The use of open pit latrines and open drinking wells in urban centres can lead to the contamination of drinking water and contribute to a spread in waterborne illnesses like E. coli, health workers said.