The Nigeria Centre for Disease Control and Prevention (NCDC) has said the country’s Lassa fever outbreak has become deadlier this year, with 221 deaths recorded and the case fatality rate rising to 24 per cent, compared with 18.7 per cent during the corresponding period in 2025.

The agency disclosed this in its Lassa fever situation report for epidemiological week 26, released on Friday.

The report also showed that confirmed infections increased during the week, with 31 new cases recorded, up from 22 in the previous reporting week.

A total of 23 states have recorded at least one confirmed case across 111 local government areas this year, highlighting the continued spread of the disease across the country.

Five states account for most infections

The NCDC reported that 85 per cent of all confirmed cases originated from Ondo, Bauchi, Taraba, Edo and Benue states, while the remaining 15 per cent were reported elsewhere.

Ondo accounted for the largest share of confirmed infections at 30 per cent, followed by Bauchi (26 per cent), Taraba (14 per cent), Edo (nine per cent) and Benue (six per cent).

People aged 21 to 30 years remained the most affected group, although confirmed cases ranged from one to 93 years.

The male-to-female ratio among confirmed cases stood at 1:0.9, indicating nearly equal infection rates between men and women.

Why deaths remain high

The NCDC attributed the elevated fatality rate to several persistent challenges, including late presentation of cases, poor health-seeking behaviour driven by the high cost of treatment, inadequate environmental sanitation in high-burden communities, low public awareness, and infections among healthcare workers.

The agency disclosed that one healthcare worker was infected during week 26.

Response efforts intensified

To contain the outbreak, the NCDC said the National Lassa Fever multi-partner, multi-sectoral Incident Management System remains activated to coordinate surveillance, case management, risk communication and response activities nationwide.

During the reporting week, the agency and its partners supported case management training for healthcare workers, active case search and contact tracing, infection prevention and control (IPC) training, community engagement activities, distribution of personal protective equipment, laboratory testing, and high-level field missions to affected states.

The NCDC urged state governments to sustain year-round community engagement on Lassa fever prevention, while healthcare workers were advised to maintain a high index of suspicion for the disease, initiate timely referral and treatment, and adhere strictly to infection prevention and control procedures.

READ ALSO: NCDC updates Lassa fever death rate to 19.3% as outbreak reaches 23 states

Lassa fever

Lassa fever is an acute viral haemorrhagic illness caused by the Lassa virus, which is transmitted to humans primarily through contact with food or household items contaminated by the urine or faeces of infected rats.

It can also spread from person to person through contact with bodily fluids.

The disease often begins with fever, weakness, and headache, and may progress to more severe symptoms such as bleeding, difficulty breathing, swelling, and organ failure.

Early diagnosis and prompt treatment with Ribavirin are critical for improving survival.

Eight-year-old Marvellous gripped a worn pencil tightly as she wrote on a single sheet of paper, kneeling on the bare concrete floor of an unfinished compound in Karshi, a satellite community on the outskirts of Abuja, Nigeria’s capital city.

Around her, four younger siblings sat barefoot, watching every movement of the pencil. Among them was a two-year-old toddler with mucus running from her nose.

The children barely noticed the visitor.

Because she is a minor, this reporter did not interview Marvellous directly. When asked if her parents were around, she quietly disappeared into the unfinished building behind her and returned moments later with her mother, Joy Kelvin.

Mrs Kelvin offered this reporter a wooden chair before settling on a stone beside the children. Behind her stood the family’s home, an unfinished three-bedroom building with exposed concrete walls and sections of roofing already beginning to deteriorate.

The structure does not belong to the family.

The owner allowed them to stay temporarily after they could no longer afford rent at their previous residence. The arrangement, however, comes with uncertainty.

“If the man decides to sell this house, we have no choice but to move again,” Mrs Kelvin told PREMIUM TIMES.

For many families, relocation is largely a housing challenge. For young children, particularly during their formative years, it can also disrupt the stability that underpins healthy development.

Frequent moves disrupt routines, friendships, schooling, and a child’s sense of security, all factors that child development experts say are essential during the early years of life.

Mrs Kelvin and her husband are raising five children on irregular incomes. She works as a domestic help while her husband is a tailor. Together, they navigate fluctuating earnings that force difficult choices about what can be paid for immediately and what must wait.

Food is often one of those choices. On some days, the family manages two meals. On other days, everyone eats only once.

Their meals consist largely of corn-based staples served with soup and whatever other food they can afford. Like many low-income households, they base their diet less on nutritional planning than on household income.

Despite these challenges, Mrs Kelvin remains determined to keep her children in school.

They attend a nearby private school, largely because the proprietor allows flexible payment arrangements.

“The owner of the school understands our condition, so she allows us to pay whatever we have, whenever we have it,” she said.

Without that flexibility, keeping the children in school would be difficult.

The family’s circumstances reflect a broader reality confronting many Nigerian households, where poverty shapes not only living conditions but also children’s opportunities to learn, play and thrive during the years experts describe as the most important period of development.

The years that shape a child’s future

Early childhood development refers to the period during which children experience rapid physical, cognitive, emotional and social growth.

Although the World Health Organisation (WHO) defines early childhood as the period from birth to age eight, child development specialists consistently identify the first five years as the most critical.

During this period, the brain develops at an extraordinary pace.

According to the United Nations Children’s Fund (UNICEF), more than one million new neural connections form every second during a child’s early years. These connections are shaped not only by genetics but also by the environments in which children grow, including the quality of nutrition they receive, the care they experience, opportunities for play and learning, housing conditions, exposure to stress and access to healthcare.

In practical terms, the environments children grow up in help shape how they learn, interact, communicate and adapt to the world around them.

For children like Marvellous and her siblings, those formative years are unfolding amid unstable housing, financial hardship and persistent uncertainty.

Inyang Ekan, a family physician working with Nigeria’s Sector-Wide Approach (SWAp) programme, said stability is especially important during early childhood because young children depend heavily on predictable environments to build emotional security and healthy social relationships.

Mr Ekan noted that stability extends beyond having a roof over a child’s head. It includes consistent relationships, familiar surroundings and routines that help children feel secure as they grow.

For families already struggling to meet basic needs, however, achieving such stability can be difficult.

When survival takes priority over stimulation

Inside Mrs Kelvin’s home, poverty influences more than where the family lives. It also shapes how every available naira is spent.

Feeding the children comes first. Other needs are considered only if money remains.

That reality became clear when Mrs Kelvin was asked whether she bought toys for her children.

“Toys?” she repeated, pausing briefly before responding.

“I can’t remember when last I got them toys. It is someone who has eaten that can buy toys.”

The response was neither dismissive nor indifferent. Rather, it reflected the practical calculations common in low-income households where every available naira is directed towards immediate necessities.

Beyond the paper in Marvellous’s hands, little suggested the kind of environment often associated with early childhood learning. Mrs Kelvin explained that the children often entertained themselves with sticks, improvised games and what she described as “children’s drama”, creating their own forms of play within the limits of what was available.

Mr Ekan says that childhood development depends on more than just food and schooling.

He noted that play, interaction, storytelling and exploration are all important components of early learning. Through play, children develop language, problem-solving abilities, creativity and social skills.

He added that developmental opportunities do not necessarily require expensive toys, but they do require stimulation and interaction.

Mr Ekan noted that siblings often play an important role in supporting early learning.

“Children can learn through teaching, guiding and playing with siblings. Simple games, storytelling, drawing and everyday objects can also support development.”

In many ways, Marvellous appeared to be performing that role. As she worked with her pencil and paper, her younger siblings watched closely, learning through observation and imitation.

However, developmental opportunities are also shaped by health and access to care.

Mrs Kelvin said she often relies on herbal remedies popularly known as “agbo” whenever her children fall ill. Formal healthcare is usually considered only when home treatment fails.

The nearest health facility, Karshi General Hospital, is geographically accessible. Financially, however, accessing healthcare is often more complicated.

Food insecurity and its developmental consequences

For Mrs Kelvin’s family, food insecurity is not simply about whether there is something to eat. It is also about whether the children consistently receive the variety of nutrients they need during the most important years of their development.

Orewole Fisayo, a paediatric nursing specialist at Mercy University Teaching Hospital in Osun State, described the first five years of life as a critical “window of opportunity” for child development.

“By age three, a child’s brain has already reached about 80 per cent of its adult size. Every nutrient a child takes in during this period is helping to build the architecture of the brain, immune system and physical body,” she said.

Ms Fisayo explained that inadequate nutrition affects far more than physical growth.

“These children do not underperform because they are less intelligent. Their brains are simply underfuelled.”

Research supports these concerns.

According to a World Bank report on Nigeria’s early childhood development outcomes, only 24.1 per cent of children aged four to six can write a simple word beyond their own name.

Just 39 per cent can correctly identify the larger of two single-digit numbers, while only 20.4 per cent demonstrate basic planning skills.

Broader indicators also reveal significant disparities in children’s access to adequate nutrition.

Data from the Nigeria Multidimensional Poverty Index show that food insecurity affects 24.1 per cent of children in Lagos, 34 per cent in Abuja, 49.5 per cent in Enugu, and 38.1 per cent in Kebbi.

Nutrition deprivation presents an equally troubling picture. While 11 per cent of children in Lagos experience nutrition deprivation, the figure rises to 12.1 per cent in Enugu, 31.5 per cent in Abuja and 54.4 per cent in Kebbi.

For households such as Mrs Kelvin’s, these statistics are reflected in everyday decisions about what food to purchase and how meals are distributed among family members.

According to Ms Fisayo, dietary diversity remains essential because no single food contains all the nutrients children require for healthy development.

Another childhood shaped by housing conditions

A few kilometres away, another family was confronting a different kind of hardship.

The first time this reporter passed through the area in Karshi, it was already evening.

Beneath a streetlight beside a row of shop compartments sat a small figure, motionless in the fading light.

From a distance, it was difficult to tell exactly what it was—a child, a shadow or simply another passing scene in a busy neighbourhood.

There was little reason to stop.

But on another evening, the figure appeared again in exactly the same place. Still beneath the same streetlight. Still alone.

Days later, on a Sunday morning, the mystery finally gave way to an answer.

People were coming out of the same row of shop compartments, moving in and out as if it were a lived-in space rather than a commercial structure. Among them were children.

The shops were not merely shops; people were living inside them.

That discovery raised a question this reporter could no longer ignore: What is it like for children to spend their earliest years growing up in a place never designed to be a home?

Living in two of the shop’s compartments was Loryoosu Ignatius, a farmer, occasional construction worker, and father of five.

When this reporter arrived, two of his sons were playing barefoot on a heap of stones beside a small corn farm behind the shops.

The older boy had just returned after calling his father from inside one of the compartments. He is eight years old. His younger brother is six.

Their three sisters, Mr Ignatius said, are in senior secondary school.

Mr Ignatius explained that his family previously lived in a rented three-bedroom apartment. Their circumstances changed after repeated thefts at his employer’s property. To protect the site, someone needed to remain there permanently.

He volunteered.

The arrangement eliminated rent but required that he relocate his family into the shop structures, where they have remained for the past three years.

“The man said he was going to come and build a standard space for my family and me, but to date, he has not come,” he said.

Inside, the family occupies two compartments. One serves as a sleeping space for the parents, while the other houses the children.

Neither room has windows.

At night, pieces of cloth are spread directly across the floor to create makeshift sleeping areas. During periods of intense heat, the family often sleeps outdoors.

“Sometimes the heat is too much, so we come outside to sleep,” he said.

For Mr Ignatius’ six-year-old son, these conditions have shaped much of his early childhood. Having spent three of his six years living in the shop compartments, he has grown up in a space never intended for family life.

His daily routine revolves around Government Primary School, Karshi, the surrounding open spaces and improvised forms of play.

Behind the shop structures, he and his brother use stones, sand, and discarded objects to create their own games, transforming the surrounding environment into makeshift playgrounds.

Despite these challenges, the family has developed ways of adapting.

Unlike Mrs Kelvin’s household, food insecurity is not their primary concern.

As a farmer, Mr Ignatius grows rice, beans, yams, and other crops. Much of what the family eats comes directly from the farm.

“We eat fruits very well. The children eat what we harvest.”

The health risks hidden within inadequate housing

The shop compartments present challenges that extend beyond overcrowding.

Poor ventilation, exposure to mosquitoes and environmental hazards all shape the children’s daily experiences.

“I have killed many snakes here,” Mr Ignatius said.

The same open spaces where the children play during the day become sources of concern at night.

Health issues have also emerged within the household. Mr Ignatius described recurring skin conditions affecting some of the children. Although he could not identify the condition by name, he demonstrated its appearance by drawing circles on his arm. He explained that he treats it at home using Ampiclox mixed with water.

While Mr Ignatius spoke about these conditions matter-of-factly, child development experts say the implications extend beyond day-to-day discomfort.

During the first five years of life, repeated exposure to illness, poor housing and environmental stressors can shape children’s physical, cognitive and emotional development in ways that may persist into later childhood.

Princess Olatubosun, a psychiatrist with the Ifedoyin and Friends Charity Organisation, said such living conditions can affect children’s health and development in multiple ways, often extending beyond the immediate risks that families notice.

Ms Olatubosun explained that poor ventilation and overcrowded living spaces can increase the risk of respiratory infections, including pneumonia and other illnesses that spread in poorly ventilated environments.

Sleeping outdoors, she added, exposes children to mosquito bites, increasing the risk of malaria and other vector-borne diseases.

According to her, prolonged exposure to excessive heat and inadequate shelter can also lead to dehydration, sleep disruption, heat stress and physical discomfort. While these conditions may appear temporary, they can affect children’s overall well-being and their ability to learn and concentrate.

She further noted that environmental conditions surrounding daily activities can create additional health risks. Children who spend significant time in outdoor environments may be exposed to smoke, environmental pollutants, contaminated water and poor hygiene conditions that can contribute to infections and other illnesses.

Frequent illness, she said, can have broader developmental consequences.

Children who are repeatedly unwell may experience reduced appetite, poor nutrient absorption and interruptions to normal growth and development.

Beyond physical health, she noted that inadequate sleeping conditions can affect sleep quality, concentration, learning ability and emotional regulation.

“Inadequate housing and lack of privacy can cause stress, anxiety and emotional insecurity in children,” she said.

She added that repeated exposure to unstable living conditions may also contribute to feelings of insecurity and social stigma, affecting children’s mental health, confidence and social development.

Learning beneath a streetlight

Each evening, the streetlight outside the shop compartments takes on a purpose beyond lighting the neighbourhood.

It becomes a classroom.

It was beneath that same light that this reporter repeatedly noticed the small figure sitting quietly in the evenings, long before discovering that families were living inside the shop structures.

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Mr Ignatius explained that his employer installed the light outside the property. With limited electricity in the shop’s compartments, his children move outdoors after sunset, setting up a small table beneath the streetlight to complete their homework.

What appears to be resilience is also evidence of deprivation.

The children are learning, but under circumstances few would choose for them.

A different beginning

Within the same community, another household presents a contrasting picture.

When this reporter visited the home of Goodness Adaoyiche, signs of childhood were immediately visible.

Teddy bears rested on a chair inside the sitting room. Children’s books and educational materials were kept in designated spaces. The environment was organised, well-ventilated and clearly structured around the needs of young children.

Mrs Adaoyiche and her husband are raising two children aged six and four.

Unlike the previous households, concerns about housing insecurity and food scarcity were absent from the conversation.

Instead, discussions centred on learning, growth and development.

Mrs Adaoyiche explained that educational activities are intentionally encouraged at home. Her younger child, currently in Nursery One, can already read simple words. To demonstrate this, she produced certificates recognising academic performance and classroom participation.

Nutrition also receives deliberate attention.

“My children eat as much as they want, sometimes five times a day,” she said.

Although food is readily available, she explained that meals are carefully balanced and regularly include fruits and other nutritious foods.

The family also provides educational toys and learning materials, replacing them whenever necessary.

The children were not at home during this reporter’s visit, but the environment itself spoke volumes.

Unlike the uncertainty that surrounded Marvellous’ family or the cramped shop compartments where the Ignatius children were growing up, this home offered predictability, stability and space to learn and play.

The contrast was about more than material possessions.

It reflected the vastly different developmental opportunities available to children growing up within the same community.

Books, toys, balanced nutrition, structured learning and stable housing combine to create an environment that nurtures healthy development during the earliest years of life.

What the data reveals

The differences observed across the three households mirror broader national patterns.

According to the Nigeria General Household Survey-Panel (GHS-Panel) Wave 5 (2023/2024), approximately 74 per cent of children in urban areas are able to complete most developmental tasks assessed in the survey, compared with only 42 per cent of children in rural areas.

The gap is particularly evident in literacy-related skills, where urban children outperform rural children across reading, writing, and letter recognition indicators.

Researchers attribute these disparities to differences in access to educational resources, household learning environments, caregiver support and broader socio-economic conditions.

The contrast between Mrs Kelvin’s unfinished home, the Ignatius family’s shop compartments and Mrs Adaoyiche’s household demonstrates how these national disparities are experienced in everyday life.

While one child grows up amid housing uncertainty and food insecurity, another navigates environmental hazards and overcrowded living conditions, while others benefit from stable homes, learning materials and consistent nutrition.

Together, their experiences show how living conditions shape developmental opportunities long before formal schooling begins.

The findings suggest that childhood development is shaped not only by individual ability but also by the environments in which children grow.

Editor’s note: The names of the children used in this report have been changed to protect their identities.