Magnitude and patterns of child sexual abuse: A retrospective cross-sectional study among male pediatric patients at Tikur Anbessa Specialized Hospital, Ethiopia

Abstract

Background: Sexual abuse of boys is a neglected problem in many developing countries, including Ethiopia. As a result, its prevalence and the circumstances under which it often occurs tend to remain unnoticed. Child sexual abuse is frequently reported to emergency departments at hospitals. However, the symptoms can be subtle and masked by vague histories and non-specific physical examinations. The objective of this study was to determine the prevalence and describe the patterns of sexual abuse of male pediatric patients at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia.

Methods: A retrospective cross-sectional study was carried out to describe causes of male pediatric sexual abuse presented to the Pediatric Emergency Unit at Tikur Anbessa Specialized Hospital between the years 2011 - 2015. The number of male children who visited the Pediatric Emergency Unit during the study period was 38,410. Out of these, 327 were suspected to have fallen victim to sexual abuse. A structured questionnaire was used to collect data from the male pediatric patients who visited the Pediatric Emergency Unit with the suspicion of sexual abuse (327).

Results: The prevalence of sexual abuse among male patients presented to the Pediatric Emergency Unit was 0.85%. Twenty-three percent of the victims were between the ages of 1 – 5 years old. The mean age of the abused children was 6.7 years (SD 2.8). The majority of the victims (67.3%) reported the abuse to their mothers. About thirty-six percent (35.8%) of the reports were made within one week of the incident. All the victims were tested for HIV on the first presentation of the incident to the emergency unit. Of those who were tested for HIV, 95.7% were negative. The majority of the perpetrators of the reported sexual abuse were from outside the home of the victims. Neighbors accounted for 55.5% of these perpetrators.

Conclusions: This study provides data for policymakers and other stakeholders to improve the well-being and safety of children. Given that the majority of incidents of male child sexual abuse occur by people children themselves know from outside their homes, strategies that involve the community and that protect children against the threat need to be designed. People to be involved may include parents, health professionals and pertinent personnel from the Ministry of Health. Others such as caregivers, schools, police department, Youth and Women’s Affairs, and child advocacy organizations should be called up on to work together and design mechanisms of checking the expansion of this public health challenge. [Ethiop. J. Health Dev. 2017;31(4):221-227]

Keywords: Male sexual abuse; Pediatric Emergency Unit; Ethiopia; Community response