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

Introduction: Prevalence of child sexual abuse in Sri Lanka ranges between 14%-44% with rates of sexual harassment as high as 78.5%. Hospital based studies done in Sri Lanka have shown a wide variation in the number presenting to hospitals with child sexual abuse. Child sexual abuse is associated with a wide range of psychosocial adversities.

Objectives: To identify the victim/perpetrator characteristics, risk factors, pattern of disclosure and psychological consequences of child sexual abuse presenting to a Teaching Hospital in Sri Lanka.

Method: This was a retrospective case review study of victims who presented to a Teaching Hospital in Sri Lanka with sexual abuse between 2015 and 2019.

Results: During the study period 164 children presented with sexual abuse. Females comprised 82.9% and 67.1% were older than 12 years. Majority (73.6%) had penetrative abuse. Multiple incidents of abuse occurred in 58.5%. Of the perpetrators, 94.5% were known to the child. Only 42.7% revealed about the incident within the first week. Delayed disclosure was higher in penetrative abuse (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% and were higher in those who delayed disclosure (p<0.05) and in those who did not disclose spontaneously (p<0.01).

Conclusions: In this study, rate of sexual abuse was 82.9% in females and 67.1% in those older than 12 years. Of the perpetrators, 94.5% were known to the child. Delayed disclosure was significantly higher in penetrative abuse (p<0.01), 

Sri Lanka Journal of Child Health, 2021; 50(4): 650-654