A prospective medico-legal study of physical and sexual child abuse in Alexandria governorate, Egypt

Abstract

Aim: Child maltreatment is one of the most prevailing violations of human rights. Limited knowledge is available regarding child abuse in Arab countries including Egypt. This article highlights the medicolegal aspects of physical and sexual abuse against children under the age of 12 years in Alexandria governorate, Egypt. Material and Methods: This is a prospective cross-sectional study that included all children under 12 years of age with reported abuse in Alexandria over a six-month period. All children underwent a general examination followed by an examination of genital and anal regions using colposcopy. Results: The study included a total of 67 children with suspected abuse; 18% physical abuse and 82% sexual abuse. Males constituted 71.64% of the children. All children with suspected intra-familial physical violence were proved to have non-accidental traumas. Delinquents had accidental and self-inflicted injuries. Anal, vaginal, and oral penetration represented 74.54% 12.72%.and 12.72% of children with suspected sexual assaults, respectively. Medicolegal evidence was present in 29% of the children with suspected sexual abuse and all children with positive medicolegal findings were sodomy victims. Discussion: Reported child abuse in the Alexandria governorate is the tip of the ice burg. Children's homes are the most dangerous places in which violence took place. Intra-familial physical abuse against young children is socially acceptable that is why only serious traumas were notified. Accidental and self-inflicted injuries were reported among delinquents. Medicolegal assessment of physical trauma usually yields firm medicolegal opinion. Sexual child abuse was more reported than physical abuse; however, sexual abuse is difficult to be proved.