Prevalence and management of child sexual abuse cases presented at Nigerian hospitals: A systematic review

• Main Author: Elizabeth Oluwatoyin Akin-Odanye
• Format: Article
• Language: English
• Published: Edizioni FS 2018-07-01
• Series: Journal of Health and Social Sciences
• Subjects: Child abuse; sexual; health services; Nigeria; psychological trauma; public health; sexual assault; violence.
• Online Access: http://journalhss.com/wp-content/uploads/jhss32_109-124.pdf
• ISSN: 2499-2240; 2499-5886

Introduction: Aim of this study was to review all suspected sexual abuse (SA) cases presenting at Nigerian hospitals, in order to examine both the prevalence of child sexual abuses (CSA) cases and the availability of hospital protocols and medical and forensic services for their evaluation, management and follow-up. Methods: A systematic review of literature including only studies published in English from 2006 to 2016 and cited in the Medline, Scopus and Web of Science databases was carried out. Results: A total of 16 hospital-based studies were included. Out of the total of 166,985 suspected SA cases presented at hospitals, only 1,553 (0.93%) of them were confirmed. Most of them (n = 1,164, 74.95%) occurred in children (< 18 years) and majority of the CSA victims were female (n = 1,155, 99.23%). HIV screening (n = 13, 81.25%) and vaginal swab (n = 8, 50%) were the most common investigations carried out by clinicians, whereas the most common medical treatments offered by the health facilities were emergency contraceptives (n = 8, 50%) and HIV post exposure prophylaxis (n = 7, 43.75%), with only a quarter of the cases (n = 4, 25%) offering any form of psychological counseling to victims and/or their parents. Written protocol for CSA evaluation and management was absent in nearly all of the health facilities. Conclusions: In Nigeria, healthcare and forensic management of CSA are poor, probably due to late presentation of victims at the hospital and to negligence on the part of health and security personnel. CSA is also possibly under-reported, with serious implications for the child and society. Prevention, proper medical treatment, management and follow-up for victims and their families, as well as making the perpetrators answerable for their crimes are highly recommended measures to tackle this issue.