Child sexual abuse presenting to a teaching hospital in Colombo, Sri Lanka

Abstract

Introduction: Prevalence of child sexual abuse in Sri Lanka ranges between 14%-44% with rates ofsexual harassment as high as 78.5%. Hospital basedstudies done in Sri Lanka have shown a widevariation in the number presenting to hospitals withchild sexual abuse. Child sexual abuse is associatedwith a wide range of psychosocial adversities.Objectives: To identify the victim/perpetratorcharacteristics, risk factors, pattern of disclosureand psychological consequences of child sexualabuse presenting to a Teaching Hospital in SriLanka.Method: This was a retrospective case reviewstudy of victims who presented to a TeachingHospital in Sri Lanka with sexual abuse between2015 and 2019.Results: During the study period 164 childrenpresented with sexual abuse. Females comprised82.9% and 67.1% were older than 12 years.Majority (73.6%) had penetrative abuse. Multipleincidents of abuse occurred in 58.5%. Of theperpetrators, 94.5% were known to the child. Only42.7% revealed about the incident within the firstweek. Delayed disclosure was higher in penetrativeabuse (p<0.01), multiple incidents of abuse(p<0.01) and abuse by a known person (p<0.05).Psychological sequelae were seen in 28.7% andwere higher in those who delayed disclosure(p<0.05) and in those who did not disclosespontaneously (p<0.01).Conclusions: In this study, rate of sexual abusewas 82.9% in females and 67.1% in those olderthan 12 years. Of the perpetrators, 94.5% wereknown to the child. Delayed disclosure wassignificantly higher in penetrative abuse (p<0.01),multiple incidents of abuse (p<0.01) and abuse by aknown person (p<0.05). Psychological sequelaewere seen in 28.7%