Ba I, Bhopal R S
Independent Researcher, Burkina Faso.
Edinburgh Migration, Ethnicity and Health Research Group (EMEHRG), Centre for Population Health Sciences, Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Public Health. 2017 Jan;142:121-135. doi: 10.1016/j.puhe.2016.07.019. Epub 2016 Sep 10.
To identify the health outcomes of sexual violence on civilians in conflict zones between 1981 and 2014.
Systematic review.
For the purpose of this study, we defined sexual violence as sexual torture including, individual rape, gang rape, and sexual slavery. All types of conflicts were included (intrastate, interstate, and internationalized intrastate). Quantitative and mixed-method studies, reporting any physical, mental, and social consequences, were retrieved from Medline, Embase, Global Health, Global Health Library, WHOLIS, Popline, and Web of Sciences (n = 3075) and from checking reference lists and personal communications (n = 359). Data were analyzed using Microsoft Excel and MetaXL. Given inherent variation, the means derived from combining studies were misleading; thus, we focused on the range of values.
The 20 studies were from six countries, five in Africa (18 studies), and especially in Democratic Republic of Congo (12 studies). The number of subjects varied from 63 to 20,517, with 17 studies including more than 100 subjects. Eight studies included males. Gang rape, rape, and abduction were the most commonly reported types of sexual violence. Sixteen studies provided data on physical outcomes of which the most common were pregnancy (range 3.4-46.3%), traumatic genital injuries/tears (range 2.1-28.7%), rectal and vaginal fistulae (range 9.0-40.7%), sexual problems/dysfunction (range 20.1-56.7%), and sexually transmitted diseases (range 4.6-83.6%). Mental health outcomes were reported in 14 studies, the most frequent being post-traumatic stress disorder (range 3.1-75.9%), anxiety (range 6.9-75%), and depression (range 8.8-76.5%). Eleven studies provided social outcomes, the most common being rejection by family and/or community (range of 3.5-28.5%) and spousal abandonment (range 6.1-64.7%).
Wartime sexual violence is highly traumatic, causing multiple, long-term negative outcomes. The number and quality of studies published does not match the significance of the problem. The findings highlight the need for care of the survivors and their relatives and raise concerns about how they and their children will be affected in the long term.
确定1981年至2014年间冲突地区性暴力对平民的健康影响。
系统评价。
在本研究中，我们将性暴力定义为性折磨，包括个人强奸、轮奸和性奴役。纳入所有类型的冲突（国内冲突、国际冲突和国际化国内冲突）。从Medline、Embase、全球健康、全球健康图书馆、世界卫生组织图书馆信息系统、人口信息数据库和科学网检索了报告任何身体、心理和社会后果的定量和混合方法研究（n = 3075），并通过查阅参考文献列表和个人交流补充了相关研究（n = 359）。使用Microsoft Excel和MetaXL分析数据。鉴于存在内在差异，合并研究得出的均值会产生误导；因此，我们关注的是数值范围。
20项研究来自6个国家，其中5项在非洲（18项研究），特别是刚果民主共和国（12项研究）。受试者数量从63人到20517人不等，17项研究的受试者超过100人。8项研究纳入了男性。轮奸、强奸和绑架是最常报告的性暴力类型。16项研究提供了身体后果的数据，其中最常见的是怀孕（范围为3.4%-46.3%）、创伤性生殖器损伤/撕裂（范围为2.1%-28.7%）、直肠和阴道瘘（范围为9.0%-40.7%）以及性问题/性功能障碍（范围为20.1%-56.7%）和性传播疾病（范围为4.6%-83.6%）。14项研究报告了心理健康后果，最常见的是创伤后应激障碍（范围为3.1%-75.9%）、焦虑（范围为6.9%-75%）和抑郁（范围为
