Household Practices Sustaining Lassa Fever Transmission in Hyperendemic Communities of Edo State, Nigeria

Background Lassa fever (LF) remains a major public health threat in Nigeria, with Edo State constituting a hyperendemic hotspot. Despite high community awareness and ongoing public health interventions, transmission has persisted, suggesting that household-level practices play a critical role in sustaining LF transmission. This study investigated household practices associated with LF transmission in Ekpoma communities, Edo State. Methods An analytical cross-sectional study was conducted among household heads or representatives selected through multistage sampling between June and August 2023. Data on socio-demographics, LF knowledge, and household practices were collected using interviewer-administered questionnaire. Associations between household practices and reported household LF incidence within the preceding 12 months were assessed using chi-square test and multivariate logistic regression. Level of significance was set at P < 0.05. Results Among 303 respondents, more than half were male (58.1%) and middle-aged (mean age: 44.6 ± 17.8 years), with farmers (26.4%) and entrepreneurs (26.1%) constituting largest occupational groups. Although 92.4% reported LF awareness and 76.6% had received community sensitisation, most households reported rodent presence (93.7%), while 53.8% stored food in open containers and 19.1% stored food on floor. Multivariate analysis shows storing food on floor (AOR = 2.32; 95% CI: 1.09–4.93) and storing food in uncovered containers (AOR = 5.02; 95% CI: 1.21–20.86) significantly increased odds of household LF risk. Conclusion A critical knowledge-to-practice gap in LF prevention exists within households in hyperendemic communities in Nigeria, with unsafe food storage practices serving as key drivers of household LF risk. Preventive strategies should prioritise structural interventions, including rodent-proof food storage and community-led environmental management.