Pattern And Presentation Of Suspected Sexual Assault: A 10-year Review In Aminu Kano Teaching Hospital

Abstract

Background: Sexual assault is a widespread crime often associated with short term and potential long term significant physical and psycho-social distress. Objective: To determine the pattern and presentation of suspected sexual assault in Aminu Kano Teaching Hospital (AKTH) from January 2008 to December 2017. Methodology: A retrospective review of patients who presented to AKTH with suspected sexual assault from 2008 to 2017 was done. Case records were retrieved and relevant information extracted on a proforma. The data obtained were analyzed using SPSS version 23 statistical software. Results: There were 102 cases of suspected sexual assault which represents 0.4% of all gynaecologic consultations. The mean age was 12.9 ± 8.8years with a range of 3-40 years. Thirty-eight (61.3%) of the survivors were children below 10 years and over a third (41.9%) of them were assaulted in their homes. Children less than 10 years were more likely to be assaulted by their neighbours (χ2=0.814, p-value 0.013). There is a statistically significant relationship between the age of the survivor and time of assault as children below 10 years were assaulted more in the afternoon (Fishers exact, p-value <0.001). More than half of the survivors presents to the hospital within 24 hours after the assault. Forty percent of the survivors had repeated sexual assault and mostly through the vagina. Thirty-four (54.8%) of the survivors had HIV screening done and 12 (19.4%) had high vaginal swab while post-exposure prophylaxis was done in 9.7%. Only 36.3% of the post-pubertal survivors were given emergency contraceptives and 28 (45.2%) of them had follow-up visits. Conclusions: The incidence of sexual assault was found to be low in this study with the survivors mostly young children below 10 years and the assailant known to them. There is delay in presentation and disclosure of the incident. Management was mostly incomplete as a lot of the victims were lost to follow up. We recommend that a proforma should be developed to capture all the necessary and relevant information from survivors and assailants with regards to the potential medico-legal pitfalls associated with it.