Suleiman Garba Auwal
Department of Community Medicine, Ahmadu Bello University Zaria, Kaduna State, Nigeria.
Institute of Child Health, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Nigeria.
J Child Sex Abus. 2023 Feb;32(2):241-258. doi: 10.1080/10538712.2023.2170844. Epub 2023 Jan 29.
Child sexual abuse affects millions of children globally but in Nigeria, hospital-based studies continue to report few cases, making it difficult to assess the magnitude and quality of care. This study aimed to overcome this challenge by reviewing police medical reports instead of hospital records. A total of 420 reports were retrieved from one police area command in Kaduna State, Northwestern Nigeria, between 2018 and 2021. The majority of the victims were females (65.5%), 5-14 years (70.2%), and familiar with their assailants (71.4%). Most of the assailants were men (99.0%), 20-40 years (29.1%), who acted alone (86.7%). Most of the reports contained history (79.3%), physical examination (49.6%), and laboratory results (>90%). Among female victims, the commonest genital findings were absent hymen (25.6%) and normal findings (17.6%). Among male victims, the commonest anal findings were normal findings (41.7%) and anal dilatation (23.6%). The victims tested positive for HIV (0.5%), hepatitis B (4.7%), hepatitis C (1.0%), and syphilis (0.8%). Higher positivity rates were noted among assailants. Treatments offered to the victims included antibiotics (30.2%), analgesics (11.9%), emergency contraception (6.7%), and psychotherapy (67.4%). The review calls for improved reporting, use of comprehensive treatment guideline, and training of service providers to improve the quality of care.
儿童性虐待影响着全球数百万儿童，但在尼日利亚，基于医院的研究持续报告的病例较少，这使得难以评估其规模和护理质量。本研究旨在通过审查警方医疗报告而非医院记录来克服这一挑战。2018年至2021年期间，从尼日利亚西北部卡杜纳州的一个警察辖区指挥部共检索到420份报告。大多数受害者为女性（65.5%），年龄在5至14岁之间（70.2%），且认识袭击者（71.4%）。大多数袭击者为男性（99.0%），年龄在20至40岁之间（29.1%），单独作案（86.7%）。大多数报告包含病史（79.3%）、体格检查（49.6%）和实验室检查结果（>90%）。在女性受害者中，最常见的生殖器检查结果是处女膜缺失（25.6%）和检查结果正常（17.6%）。在男性受害者中，最常见的肛门检查结果是检查结果正常（41.7%）和肛门扩张（23.6%）。受害者的艾滋病毒检测呈阳性（0.5%）、乙型肝炎（4.7%）、丙型肝炎（1.0%）和梅毒（0.8%）。袭击者的阳性率更高。为受害者提供的治疗包括抗生素（30.2%）、镇痛药（11.9%）、紧急避孕（6.7%）和心理治疗（67.4%）。该审查呼吁改进报告、使用综合治疗指南并对服务提供者进行培训，以提高护理质量。
