The incidence, pattern and management of sexual assault in a tertiary hospital in North-western Nigeria

Abstract

Background: Sexual assault is any sexual act performed by one person on another without the person’s consent or on a victim who is incapable of giving consent. It is a violation of basic human rights, a gender-based issue and a violent crime against both the individual and the society. The objectives of the study were to determine the incidence, pattern and management of sexual assault in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.Methods: This was a 10 - year retrospective study. Case records of sexual assault from 1st January, 2007 to 31st December, 2016 were retrieved and relevant data extracted and analyzed using the SPSS for windows version 20.0Results: The incidence of sexual assault was 0.8%. Majority, 88 (85.4%) occurred in children and adolescents. Peno-vaginal penetration was the most common form of assault 65 (63.1%) and the assailants were known to the victims in 74 (71.9%) of the cases. Involvement of psychiatrists/psychologists in the management of the victims was poor as psychiatrists were involved in only 13 (12.6%) of the cases. Most of the victims were lost to follow up.Conclusions: Sexual assaults occurred mostly in children and adolescents in this study. Increased public awareness and preventive interventions are required especially among the at-risk age groups to enhance their safety. Training of relevant persons in the institution to offer counselling to the victims is recommended as referral for psychiatrists’ consultation was poor. It is important to institute a good tracking system to follow up the victims as most are lost to follow up.

Circumstances and Consequences of Violence-Related Injuries Presenting at Hospital. A Study at the Pediatric Emergency and Forensic Medicine Units of Maputo Central Hospital, Mozambique

“…In fact, as indicated earlier, acts of violence occur usually in settings that the child is familiar with. Additionally, girls spend more time in the home [8][9][10].…”

“…Yet, children sustain sexual and physical violence in their home or at that of the perpetrator, which often is a person they know [8,9]. The vast majority of perpetrators of sexual violence are males, typically a parent or a relative, while physical 2 of 12 violence is also inflicted by women (usually a mother) but in lower proportions than men [10][11][12]. This is not surprising given that these children are more likely to be left alone with relatives, neighbors, and friends while their parents work, placing them at a higher risk of assault [13][14][15][16].…”

“…In the SSA region, a vast majority of children are subjected to some form of psychological aggression and physical punishment at home on a yearly basis [6]. There are quite a few peer-reviewed scientific studies on violence and violence-related injuries in children in the region, in particular from South Africa [15,16,[21][22][23][24][25][26][27][28][29][30] but also from Nigeria [10,[31][32][33], Mozambique [11,12,[34][35][36][37][38][39], Ethiopia [40][41][42][43], Zimbabwe [5,14,[44][45][46], Uganda [35,47], Ghana [13,34], Malawi [48,49], Tanzania [50,51], and Zambia [52]. While data on violence-related injuries are from hospital records [10,15,16,26,…”

“…Hospital-based studies on sexual violence against girls show a tendency for younger girl victims of violence to sustain more severe injuries [15], which may be attributable to a less developed genital area, related to low levels of estrogen, the hormone responsible for development and maintain the reproductive system, and elasticity of tissues. Overall, girls presented with genital injuries, such as lacerations, bruises and erythema, and boys presented with anal injuries [10]. Not surprisingly, the absence of injuries in the genital area, particularly in girls, is often reported due to a delay in disclosure [29,30].…”

“…Not surprisingly, the absence of injuries in the genital area, particularly in girls, is often reported due to a delay in disclosure [29,30]. For those presenting with acute and severe injuries, a small number needed emergency surgical treatment [10,32]. As for physical violence, while boys are more afflicted than girls, the injuries sustained are similar: mainly injuries to soft tissues, followed by bone fractures and penetrative wounds [2,40,53].…”