Years of violence by Islamist Boko Haram militants have taken a “devastating toll” on children living in the Lake Chad basin, the United Nations Children’s Fund (UNICEF) said on Thursday.

The insurgency displaced 1.4 million children in Nigeria, Cameroon, Chad and Niger and left at least another one million trapped in areas that are hard to reach or under the control of Boko Haram, the agency said.

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An estimated 475,000 children across Lake Chad are expected to suffer from severe acute malnutrition this year, up from 175,000 at the beginning of the year, according to the report.

“Humanitarian needs are outpacing the response,” warned UNICEF regional director for West and Central Africa Manuel Fontaine.

In north-eastern Nigeria alone, where Boko Haram has its strongholds, an estimated 20,000 children have been separated from their families.

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About 38 children have been used to carry out suicide attacks in the Lake Chad basin so far this year, the UN said, bringing to 86 the number of children used as suicide bombers since 2014.

Earlier this week, the World Food Programme warned that the number of people who need food aid in north-eastern Nigeria has almost doubled to 4.5 million between March and August.

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Boko Haram poses a steady threat to communities in the north-east of Nigeria and has also launched offensives in neighbouring Chad, Niger and Cameroon.

Since 2009, at least 14,000 people have died at the hands of the Sunni fundamentalists.

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