الفهرس | Only 14 pages are availabe for public view |
Abstract Child abuse is a maltreatment of a child that was defined as any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child.There are four major categories of child abuse: sexual abuse, physical abuse, psychological abuse and neglect abuse, and can occur in a child’s home, organizations, schools or communities with which the child interacts. Child abuse constitutes a violation of the most basic rights of children and adolescents, which are enshrined in the Universal Declaration of Human Rights. Child abuse is a complex problem that can have lasting harmful effects on its victims. The first step in treatment and prevention of this problem should be started with determination of its extent and characteristics. However, information concerning the problem of child abuse in Egypt is scanty and scattered. This study aimed to investigate the pattern of child abuse in cases referred for medico legal examination in Cairo and Giza governorates in the period between 2007- 2011.The files of all cases of child abuse that were referred to Medico-legal Department Office and Zen hum Morgue during the study period were thoroughly revised and the following data were obtained; demographic data (age, gender and residence governorate), referring authority, type of child abuse, findings of examination of the abused child, relation between the abused child and perpetrator and cause of death in mortality cases. This study included 922 cases of child abuse that represented 4.4% of the total number of the referred cases to medicloegal authorities during the study period (20,952 cases). There was none significant difference in the proportions of sexual and physical child abuse between the included five years in the study period (2007- 2011). There was no statistically significant difference between Cairo and Giza in the frequencies of child abuse, either sexual or physical type. Sexual abuse was much more prevalent than physical abuse (813 cases, 88.2% vs. 109 cases, 11.8%). The most common regions referring cases of child abuse in Cairo were Ain Shams and Matareya (sexual: 58 cases, 14.6% and physical: 11 cases, 18.1% from each one) while Haram was the most common region in Giza (sexual: 109 cases, 26.2% and physical: 12 cases, 25%).Female gender was more predominant than male gender as victims of physical and sexual abuse (62.4% and 52.8% respectively) although there was no statistically significant difference between both genders. School age group followed by adolescents, represented the greatest proportion of victims of child sexual abuse (92.1% and 91.5% respectively). Toddlers represented the greatest proportion of victims of physical abuse (71.1%) and they were the least frequent age group exposed to sexual abuse among the included cases (28.9%). In sexual abuse females were predominant in adolescents and toddlers (76.7% and 54.5% respectively), while males were predominant in school age and preschool age groups (72.9% and 64.9% respectively). Stranger persons were the most frequent perpetrator of child sexual abuse (381 cases, 46.9%) of both genders of the victims (158 cases, 36.8% in females and 223 cases, 58.1% in males). Anal injuries were evident in 15% of victims of child sexual abuse (122 cases). Acute anal injuries were more frequent than chronic injuries (10.1%, 82 cases vs. 4.9%, 40 cases). There was significant increase in frequency of acute anal injury in male victims (17.7%, 68 cases) in comparison to that in female victims (3.3%, 14 cases).The greatest frequency of vaginal injuries (both acute and chronic) was in adolescents group (36.8%, 110 cases) while there was no cases with vaginal injures in toddlers group. The greatest frequency of acute vaginal injuries was found in victims of child sexual abuse by stranger persons (55.6%, 15 cases) while the greatest frequency of chronic vaginal injuries was found in victims of sexual abuse by adults friends (51.8%, 45 cases). There was concomitant physical violence with sexual abuse in 14.9% of victims of sexual abuse (evidenced by wounds), contusions were the most common type of wound and limbs were the most common body areas affected by physical injuries. |