Evaluating the medical care of child sexual abuse victims in a general hospital in Ibadan, Nigeria.

Abstract

OBJECTIVES: Evaluation of the medical care provided to victims of Child Sexual Abuse (CSA). DESIGN: A retrospective cross sectional study. SETTING: The general outpatient clinic of a 150 bed secondary health care facility in Ibadan, Nigeria. PARTICIPANTS: Children < 18 years who were treated as Victim's sexual assault. MAIN OUTCOME MEASURE: Investigations and treatment prescribed for CSA victims. RESULTS: The median age of victims was 12 years (range 3-17 years). All were females and 33.3% had attained menarche. Many (68.1%) had torn hymen; of these, 16.3 % also had vaginal lacerations and bleeding. Children>10 years more often had torn hymen (P<0.001). Vaginal swab microscopy was done in 84.0% of those with torn hymen. About 60% of victims had retroviral screening done (all were non reactive) the retroviral screening of the perpetrator was requested in only case. None of the patients received post exposure prophylaxis for HIV. Of those with signs of vaginal penetration who had also attained menarche 12.2% had emergency contraceptives prescribed. Treatment of victims consisted mostly of antibiotics--47.2% and analgesics--37.5% with only 15.3% of patients proffered any form of counselling. CONCLUSIONS: There is a still a huge gap between the health care needs of victims of CSA and the medical services provided for victims of CSA. The use of a treatment protocol and additional training for health care providers in the management of CSA victims is encouraged.

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