Title : Factors associated with interpretation of physical exam findings among child sexual abuse victims assessed at the women and children protection unit in a tertiary government hospital: A retrospective study
Abstract:
Introduction: Child sexual abuse (CSA) is a health emergency associated with devastating physical, behavioral, interpersonal and psychological consequences for survivors. Because children rarely disclose sexual abuse immediately, the physical examination (PE) is often delayed, and most injuries have healed by consultation time.
Objective: To describe the socio-demographic, incident and clinical profiles of CSA victims and their association to PE findings.
Methodology: This is a retrospective analytical study with 132 randomly selected CSA medicolegal certificates. A researcher developed data collection tool was used for collation. Descriptive statistics and chi-square analyses were utilized.
Results: Most CSA victims were 12 to 18 years old (72.73%), from rural areas (69.70%), abused multiple times (58.33%) and were students (95.45%). Majority have been assessed after >72 hours (73.48%). Half were abused between 12:00 PM to 11:59 PM, usually at their own home (54.55%) by a relative (57.58%). Most already had menarche (74.24%) while many had Tanner breast (39.39%) and pubic hair (39.39%) maturity at Stage 3. The perineum and anal examinations showed no lesions in almost all (96.21%), many had hymenal lesions (78.79%) and half had vaginal discharges. Majority had PE findings suspicious for sexual abuse (75%). These are significantly associated with interpretation of CSA PE findings: age, occupation, weight, height, menarche, breast and pubic hair Tanner staging, hymen and vaginal discharge.
Conclusion: Majority of CSA victims are 12 to 18 years old, abused by relatives in the home. These have significant association with PE findings: age, occupation, weight, height, menarche, breast and pubic hair Tanner staging, hymen and vaginal discharge.
Keywords: Child sexual abuse, medico-legal, profile.
Audience Take Away:
- The findings of this study may provide OB-GYN practitioners a clearer insight and raise their levels of suspicion for CSA victims through their characteristics despite nondiagnostic PE findings.
- The findings of this study may help other health practitioners understand the clinico-demographic, incident and clinical profiles of child sexual abuse victims and make necessary referrals to appropriate authorities.
- The findings of this study will help women and child protection units to better serve sexually abused and at-risk children with compassion and competence.
