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I had the problem of jerky graphics regardless of the framerate. After trying a bunch of different things with no success I realized it was a similar problem to that of Jade Empire. I thought it was a long shot, but I tried the file from the Jade Empire fix with Children of the Nile and it's now smooth as butter.

https://www.gog.com/forum/jade_empire_special_edition/stuttering_fix

All credit to fk. of the GOG forums. Hope this helps.
Nice find! I copied it into the CotN folder and now the game runs beautifully. Thanks!
Worked like a charm!

I didn't need to run `vcredist_x86.exe` installer. All I needed was the dll file and CotN runs fine now.
Sorry for the necro, but I just tried this and all it did was cause an error when I start up the game. Does anyone have any ideas?
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CatteBurglar: Worked like a charm!

I didn't need to run `vcredist_x86.exe` installer. All I needed was the dll file and CotN runs fine now.
Where did you put the DLL file?
The fix suggested here using the alternate dx9.dll works. Game went from chug-fest, frame skipping to smooth as glass. Thank you to all who participated in finding and creating this.