Sexual abuse in Ziguinchor, Senegal: Epidemiology and management
##plugins.themes.academic_pro.article.main##
Abstract
aims: To determine the frequency of sexual abuse, establish the demographic profile and to evaluate the care of victims of sexual abuse in Ziguinchor.
methods: That is a retrospective, descriptive study from February 1, 2008 to August 31, 2010, including all patients received in the Department of Gynecology and Obstetrics, Ziguinchor Regional hospital for sexual abuse. For each patient, data analyzed were sociodemographic data, characteristics of aggression, clinical implications and psychological support. The data were entered and analyzed using the Excel 2003 version.
results: 50 cases of sexual abuse were collected on 4950 patients, a prevalence of 1%. The average age of victims was 13 years (range: 3 to 23 years). The abuse took place in the day in 60% of cases. The location was familiar to victims in 70% of cases. The notion of penetrative genital contact was reported in 74% of victims. Physical force or a weapon was used in 34% of cases. The offender was 30 years old in 86% and operated alone in 92% of cases. Half of the victims had consulted in the first 24 hours. Genital trauma was found in 82% of victims.
Feelings of fear, shame, or anger was observed in 64% of patients. Antibiotic was prescribed in two-thirds of the victims as postexposure prophylaxis for HIV was performed in only five patients. Emergency contraception was prescribed in 34% of victims. Six pregnancies were recorded. Six patients had developed complications such as depressive syndrome, hysteria with severe epileptiform seizures, mood disorder and psychosis. A proportion of 26% of victims did not consider it necessary to have recourse to justice.
Conclusion: The management of a victim of sexual abuse should not stop at a forensic evaluation. We must therefore endeavor to provide a solution to three important consultation which are medical care, legal and emotional.
methods: That is a retrospective, descriptive study from February 1, 2008 to August 31, 2010, including all patients received in the Department of Gynecology and Obstetrics, Ziguinchor Regional hospital for sexual abuse. For each patient, data analyzed were sociodemographic data, characteristics of aggression, clinical implications and psychological support. The data were entered and analyzed using the Excel 2003 version.
results: 50 cases of sexual abuse were collected on 4950 patients, a prevalence of 1%. The average age of victims was 13 years (range: 3 to 23 years). The abuse took place in the day in 60% of cases. The location was familiar to victims in 70% of cases. The notion of penetrative genital contact was reported in 74% of victims. Physical force or a weapon was used in 34% of cases. The offender was 30 years old in 86% and operated alone in 92% of cases. Half of the victims had consulted in the first 24 hours. Genital trauma was found in 82% of victims.
Feelings of fear, shame, or anger was observed in 64% of patients. Antibiotic was prescribed in two-thirds of the victims as postexposure prophylaxis for HIV was performed in only five patients. Emergency contraception was prescribed in 34% of victims. Six pregnancies were recorded. Six patients had developed complications such as depressive syndrome, hysteria with severe epileptiform seizures, mood disorder and psychosis. A proportion of 26% of victims did not consider it necessary to have recourse to justice.
Conclusion: The management of a victim of sexual abuse should not stop at a forensic evaluation. We must therefore endeavor to provide a solution to three important consultation which are medical care, legal and emotional.
Keywords:
Sexual abuse, care, impact, Ziguinchor, Senegal##plugins.themes.academic_pro.article.details##
References
- Jewkes R, Sen P, Garcia-Moreno C. Sexual violence. World report on violence and health. Geneva: World Health Organization; 2002, p. 213-239.
- World HealthOrganization. Gestion clinique des victimes de viol: développement de protocoles à adopter avec les réfugiés et les personnes déplacées dans leur propre pays. Organisation mondiale de la Santé II. UNHCR. Ed. Rév.2005
- Faye-Diéme ME, Traoré AL, Guéye SMK, Moreira PM, Diouf A, Moreau JC. Profillépidémioclinique et prise en charge des victimes d'abus sexuel à la clinique gynécologique et obstétricale du CHU de Dakar. J Gynécol Obstet Biol Reprod 2008; 37: 358- 64.
- Traore AM. Violences sexuelles: aspects cliniques en consultation gynécologique dans le service de gynécologie-obstétricale de l'hôpital Gabriel Touré à propos de 115 cas. Thèse, médecine, Bamako, 2002, n°152
- Elliot DM, Mok DS, Briere J. Adult sexual assault: prevalence symptomatology and sex differences in the general population. J Traumatic Stress 2004; 17: 203- 11.
- Nathalie B, Michel B. Les violences sexuelles en France: quand la parole se libère.Population & Sociétés. Mai 2008; n° 445.
- MbassaMenick D. La problématique des enfants victimes d'abus sexuels en Afrique ou l'imbroglio d'un double paradoxe: l'exemple du Cameroun. Child Abuse Neg 2001; 25: 109-21.
- Adams JA. Approach to the interpretation of medical and labotory findings in suspected child sexual abuse: a 2005 revision. APSAC Advisor 2005; 17:7-13
- Brostein S. Violence et agression sexuelle: la violence. Psycho Med 1992 ; 24, 10 : 1017-19.
- Code de procédure pénale au Sénégal. Ministère de la justice du Sénégal.
- Boutin L. Prise en charge d'une victime d'agression sexuelle. Real GynecolObstet 2001; 64:32-6.
- Guillet-May F, Judlin P, Pichene C, Peton P. Les violences sexuelles: nécessité d'une prise en charge multidisciplinaire. Contracept Fertil Sex 1997; 25:1-3.
- Soutoul JH, Chevrant BG. Les agressions sexuelles de l'adulte et du mineur. Paris: Ellipses; 1994.
- MarsaudO.Les viols, plaies des écoles Sud Africaines; OMS, Avril 2001 : p.222-230.
- Toure B. Viol et tentatives de viol à propos de 43 cas au Burkina- Faso. 6ème congrès de la SAGO. 2000; 4-8 Déc.