Characteristics of Child Sexual Abuse in Zambia

Abstract

Child Sexual Abuse (CSA)is a problem in many countries in the world including Zambia. The effects of CSA are both physical (genital trauma, contraction of infections, pregnancy, etc) and psychosocial (emotional dysregulation, bed wetting, regression of milestones, relational problems, poor self-esteem and other psychiatric diagnosis such as depression, eating disorders, substance misuse disorders, dissociative anxiety disorders, anxiety disorders, posttraumatic stress disorder (PTSD), etc). As a result of its effects, CSA is a psychiatric emergency. However, little data exists in subsaharan Africa). Knowing the characteristics of CSA in our setting, aids early identification and intervention.
Objective: To describe the characteristics of child sexual abuse (CSA) among sexually abused children from the CSA centre at University Teaching Hospital (UTH).
Design: Cross-sectional study based on information from CSA centre records of children aged 4 to 15 years.
Main Outcomes: There were 192 participants in the study with only 3 boys. Teenagers constituted almost 50% of the study population with median age = 13, mean age = 11. Ninety eight percent of the referrals were from the Police. All the abusers were maleswith neighbours, boyfriends and non-relative adults constituting over 50% of the abusers in the study. Penile penetration was the main feature of the abuse with only one in twenty abusers being reported to have used condoms. Physical Force was the main mode of engagement used on the children.
Conclusions: Most of the sexual abuse involves unprotected penetrative sex. The police should be included in planned care for CSA victims.