Epidemiological, Clinical Aspects and Treatment of Victims of Sexual Abuse in the Gynecology and Obstetrics Department of Pikine National Hospital in 183 Cases

摘要

Introduction: Sexual abuse or sexual assault is part of violence against women, as is physical violence, female genital mutilation and forced marriage. According to the Criminal Code, this is any sexual offense committed with violence, coercion, threat or surprise on the person of others. It is a criminal act punishable by the laws in force in almost every country in the world. Study Objectives: 1) draw up an epidemiological profile of female victims of sexual abuse;2) develop the treatment protocol. Methodology: This is a 7-year descriptive retrospective study from January 1, 2010 to December 31, 2016 at the Center Hospitalier National de Pikine (Dakar). Included in this study were all of the patients admitted during our investigation period who were the victims of suspected or certain sexual abuse, with or without requisition. For each case, the following parameters were studied: the epidemiological characteristics (age, gestation, parity and place of residence), the circumstances of the attack (time and place), the characteristics of the aggressor (age, link with the victim, number of aggressor), the type of sexual contact, the possible lesions found during the physical examination (genital and extra-genital), the mode of admission, the delay of the consultation, the attitude after the sexual abuse, the gynecological and obstetrical status of the victim, the repercussions and psychological follow-up, the paraclinical assessment, the treatments administered. Data were collected using a survey form and analyzed with SPSS software. Results: During the study period, 183 victims of sexual abuse were received and treated at the level of our structure out of a total of 39,760 patients, representing a frequency of 0.46%. The age of the victims varied between 2 and 36 years with an average of 13 years. The 11 to 15 age group was the most represented. Students were the most represented among victims of sexual abuse (87.4%). Workers represented 9.3% of the victims. Infants made up 3.3% of the victims;the average age of the alleged attackers was 31 when they were known to their victim. Half of the victims (50.3%) were in the pre-pubertal stage. Among those who were in genital activity (91 cases or 49.7%), 16 cases of pregnancy were reported;which represented 8.7% of cases. Only 20.2% of victims had genital trauma. Prescription of emergency contraception was carried out for 47% of the victims who were in genital activity. After the clinical examination, 17% of the victims had received antibiotic prophylaxis. Conclusion: Sexual abuse is currently a real socio-cultural drama. Preventing them involves raising public awareness. Their management must be early and adapted in order to prevent sexually transmitted infections and psychological consequences.