Ige Ok, Fawole O I
Department of Community Medicine, University College Hospital, Ibadan, Oyo 20001, Nigeria.
Ghana Med J. 2012 Mar;46(1):22-6.
Evaluation of the medical care provided to victims of Child Sexual Abuse (CSA).
A retrospective cross sectional study.
The general outpatient clinic of a 150 bed secondary health care facility in Ibadan, Nigeria.
Children < 18 years who were treated as Victim's sexual assault.
Investigations and treatment prescribed for CSA victims.
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.
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.
评估为儿童性虐待（CSA）受害者提供的医疗护理。
一项回顾性横断面研究。
尼日利亚伊巴丹一家拥有150张床位的二级医疗保健机构的普通门诊。
18岁以下被当作性侵犯受害者治疗的儿童。
为CSA受害者开出的检查和治疗方案。
受害者的中位年龄为12岁（范围3 - 17岁）。均为女性，33.3%已初潮。许多人（68.1%）处女膜破裂；其中16.3%也有阴道撕裂和出血。10岁以上儿童处女膜破裂的情况更常见（P<0.001）。84.0%处女膜破裂的患者进行了阴道拭子显微镜检查。约60%的受害者进行了逆转录病毒筛查（结果均为阴性），仅1例要求对犯罪者进行逆转录病毒筛查。没有患者接受HIV暴露后预防。在有阴道穿透迹象且已初潮的患者中，12.2%开具了紧急避孕药。对受害者的治疗主要包括抗生素（47.2%）和镇痛药（37.5%），只有15.3%的患者接受了任何形式的咨询。
CSA受害者的医疗保健需求与为他们提供的医疗服务之间仍存在巨大差距。鼓励采用治疗方案并对医疗保健提供者进行CSA受害者管理方面的额外培训。
