Medico-Legal evaluation of child sexual abuse over a six-year period from 2004 to 2009 in the Suez Canal area, Egypt

BackgroundSex crimes are complex and multidimensional; over the past few decades, child sexual abuse has gained public attention and become one of the most high-profile crimes. Since the 1970s, sexual abuse of children and child molestation has increasingly been recognized as deeply damaging to children and unacceptable for society as a whole.MethodsThis is a retrospective and prospective study evaluating sexual assault against children in the Suez Canal area in Egypt from 2004 to 2009, assessing the prevalence of sexual assault and associated factors among its victims. Examination was carried out in the Medico-Legal department of Ministry of Justice, Suez Canal area including Ismailia, Port-Said, El-Suez, and North Sinai cities.ResultsThere were 128 cases in the age range of 5–18 years (53.9% girls and 46.1% boys). Of these cases, 88.3% were between 10 and 18 years old, and 11.7% were between 5 and 10 years old. Those living in urban areas comprised 83.6% of the cases, and 16.4% lived in rural areas. Intra-familial assailants comprised 13.3% of the cases, while 86.7% were extra-familial to the victims. From the intra-familial cases, 35.3% of the cases were incest against girls and 29.4% cases were intra-familial sodomy against boys. In 63.1% of the cases, the assailants were unknown to the victim; 18.7% reported sexual assault by more than one attacker, and 7.1% of cases reported sexual assault combined with physical assault. The most frequently reported types of abuse were anal assault (52.3%) followed by incomplete vaginal penetration (36%) and complete vaginal penetration (7.8%). Mixed assaults − vaginal and anal – occurred in 3.9% of the cases. Sexual assault was made under verbal threat in 39% of the cases, while sexual assault was made under armed threats in 3.9% of cases. In 34.4%, examination of the victims was done within 3 weeks of the assault; in 26.6% of cases, examination was done within 2 weeks; in 14.8%, examination of the child was done after 1 month, and in 10.2% of cases, examination was done within 2–4 days of the crime.ConclusionsDoctors and other health professionals should be aware of the high prevalence rate of child abuse and its potential for initial and long-term deleterious outcomes.