Department of Legal Medicine, Faculty of Medicine of Sousse, Ibn El Jazzar Teaching Hospital of Kairouan, 3100, Kairouan, Tunisia.
Department of Obstetrics and Gynaecology, Faculty of Medicine of Sousse, Ibn El Jazzar Teaching Hospital of Kairouan, 3100, Kairouan, Tunisia.
BMC Womens Health. 2022 Mar 8;22(1):64. doi: 10.1186/s12905-022-01647-8.
Despite the abundance of studies reporting the prevalence of women's sexual abuse all over the world, there is a real lack of such reports in developing countries in general and Arab-Muslim societies in particular. However, due to the little number of published studies in Tunisia, and the absence of a national database, data on female sexual assaults are still underestimated, which is a gap that needs to be filled in order to make specific preventive actions. We aim to identify the pattern of female victims of sexual abuse in the governorate of Kairouan (Tunisia) in order to provide recommendations for prevention.
Retrospective data were collected on all-female sexual assault victims, particularly rape, presented to the Department of Forensic Medicine of the University Hospital Ibn El Jazzar of Kairouan (Tunisia), during an 8-year period, from 2009 to 2016.
Two hundred and sixteen victims were included. Age ranged from 3 to 82 years with a mean age of 20.4 years. Victims were single in 84.3%, unmarried in 90.7% and they lived in rural areas in the majority of cases. Rape was committed by a single individual in 94.9% of cases, and the assailant was a stranger in only 26.8%. The assault occurred most frequently in the assailant's home (73.6%) or the public places (11.6%). Evidence of recent acute general body trauma was found in 41.2% of the victims, and the most common injuries were located on the thigh, upper arm, and chest. In 28.1% of the cases, injuries were seen in the face and the neck. Genital examination showed that 188 victims (87%) had a tear in the hymenal membrane and only 13% of victims had intact hymenal membrane. A complacent hymen was noted in 2.3%. A recent anal lesion was seen in 8.3% of the cases. Cytology was performed on 78 victims. In 22 cases (28.2%), sperm could be detected in vaginal swabs up to 3 days post-assault, and pregnancy was seen in 7.4% of assault victims.
Sexual abuse represents a human rights and public health problem that is thriving in a culture of silence, particularly in the Arab region. There is a particular need to create a Tunisian national database on female sexual assaults, in order to centralize data and provide holistic follow-up for specific preventive measures. Finally, efficient management of such cases will need, in addition to legislation, a partnership between the various actors involved in taking care of the victims (health care professionals, the police, social specialists, and psychologists). In addition, civil societies are key partners to break the silence, support this issue, and raise awareness.
尽管有大量研究报告了全世界女性性虐待的流行情况，但在一般发展中国家，特别是在阿拉伯-穆斯林社会，这种报告实际上非常缺乏。然而，由于突尼斯发表的研究数量较少，且缺乏国家数据库，因此女性性侵犯的数据仍然被低估，这是一个需要填补的空白，以便采取具体的预防措施。我们旨在确定凯鲁万省（突尼斯）女性性虐待受害者的模式，以便为预防提供建议。
回顾性收集了 2009 年至 2016 年期间，8 年来在凯鲁万伊本·哲扎尔大学医院法医系就诊的所有女性性侵犯受害者，特别是强奸受害者的资料。
共纳入 216 名受害者。年龄 3 至 82 岁，平均年龄 20.4 岁。84.3%的受害者为单身，90.7%未婚，大多数受害者居住在农村地区。94.9%的病例是由单一袭击者实施的强奸，只有 26.8%的袭击者是陌生人。袭击最常发生在袭击者的家中（73.6%）或公共场所（11.6%）。41.2%的受害者有近期急性全身创伤的证据，最常见的损伤位于大腿、上臂和胸部。28.1%的病例可见面部和颈部受伤。外阴检查显示 188 名受害者（87%）处女膜破裂，只有 13%的受害者处女膜完整。2.3%的处女膜可见兴奋。8.3%的病例可见近期肛门损伤。对 78 名受害者进行了细胞学检查。在 22 例（28.2%）中，阴道拭子中可在创伤后 3 天内检测到精子，7.4%的性侵犯受害者怀孕。
性虐待是一个人权和公共卫生问题，在阿拉伯地区尤其存在于沉默的文化中。特别需要建立一个关于女性性侵犯的突尼斯国家数据库，以便集中数据并为特定的预防措施提供全面的后续服务。最后，除了立法之外，还需要涉及照顾受害者的各个行为者（医疗保健专业人员、警察、社会专家和心理学家）之间的伙伴关系，才能有效地处理此类案件。此外，民间社会是打破沉默、支持这一问题和提高认识的关键伙伴。
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