An analysis of child sexual abuse seen in a teaching hospital of a developing country

Abstract

Abstract Background Child sexual abuse (CSA) continues to expand in scope and character and in developing countries is fuelled by poverty, poor policies, and cultural perceptions and practices. It is poorly studied or under-reported in sub-Saharan Africa. This may be due to the taboo placed on sex and ignorance of the consequences of child sexual abuse. The objective of this study was to analyze the characteristics of CSA seen in our environment. An interviewer-administered questionnaire was used to obtain information about children attending a forensic clinic with a history of sexual abuse. Information was obtained from the child and/or an accompanying adult. Descriptive statistics were performed on obtained data. Results In the study period, CSA cases represented 72.4% of sexual assault; 98.4% of victims were females. Victims’ average age was 10.2±4.2 years (95% CI 9.47–10.93), most (61.1%) lived with both parents, and most presented for care after 72 h of the incident. Most parents/guardians were low-income earners with only secondary education. Most perpetrators (75.6%) were known to their victims and were predominantly artisans (36.6%), while most (43.5%) were aged from 21 to 30 years and 18.3% were adolescents; a greater proportion was unmarried or widowed (52%). The abuse occurred mostly in the perpetrator and victim’s home (56.4%). Inducement with gifts and promises (65.1%) was the most means of procuring CSA; in 21.4% of cases, victims were exposed to pornography before the act. Penis (64.3%) and finger (26.2%) were mostly used. Most victims did not sustain injuries (68.6%) and presented without symptoms (64.3%), while 35 (27.7%) had genitourinary symptoms. Conclusions In our environment, sexual abuse of children is commoner than that of adults and has characteristics that make it potentially more problematic than usual including a proportionately high number of adolescent perpetrators and involvement of pornographic materials. Preventive measures should be geared towards these and other aspects of the problem.

Keywords

• Child sexual abuse
• Victims
• Perpetrators
• Characteristics
• Developing country
• Adolescent perpetrators