الفهرس 
Child AbuseOnly 14 pages are availabe for public view
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Abstract
Child abuse is a maltreatment of a child that was
defined as any act or series of acts of commission or
omission by a parent or other caregiver that results in harm,
potential for harm, or threat of harm to a child.There are
four major categories of child abuse: sexual abuse, physical
abuse, psychological abuse and neglect abuse, and can
occur in a child’s home, organizations, schools or
communities with which the child interacts.
Child abuse constitutes a violation of the most basic
rights of children and adolescents, which are enshrined in
the Universal Declaration of Human Rights. Child abuse is
a complex problem that can have lasting harmful effects on
its victims. The first step in treatment and prevention of this
problem should be started with determination of its extent
and characteristics. However, information concerning the
problem of child abuse in Egypt is scanty and scattered.
This study aimed to investigate the pattern of child
abuse in cases referred for medico legal examination in
Cairo and Giza governorates in the period between 2007-
2011.The files of all cases of child abuse that were referred
to Medico-legal Department Office and Zen hum Morgue
during the study period were thoroughly revised and the
following data were obtained; demographic data (age,
gender and residence governorate), referring authority, type
of child abuse, findings of examination of the abused child,
relation between the abused child and perpetrator and cause
of death in mortality cases.
This study included 922 cases of child abuse that
represented 4.4% of the total number of the referred cases
to medicloegal authorities during the study period (20,952
cases). There was none significant difference in the
proportions of sexual and physical child abuse between the
included five years in the study period (2007- 2011). There
was no statistically significant difference between Cairo
and Giza in the frequencies of child abuse, either sexual or
physical type.
Sexual abuse was much more prevalent than physical
abuse (813 cases, 88.2% vs. 109 cases, 11.8%). The most
common regions referring cases of child abuse in Cairo
were Ain Shams and Matareya (sexual: 58 cases, 14.6%
and physical: 11 cases, 18.1% from each one) while Haram
was the most common region in Giza (sexual: 109 cases,
26.2% and physical: 12 cases, 25%).Female gender was more predominant than male
gender as victims of physical and sexual abuse (62.4% and
52.8% respectively) although there was no statistically
significant difference between both genders.
School age group followed by adolescents,
represented the greatest proportion of victims of child
sexual abuse (92.1% and 91.5% respectively). Toddlers
represented the greatest proportion of victims of physical
abuse (71.1%) and they were the least frequent age group
exposed to sexual abuse among the included cases
(28.9%). In sexual abuse females were predominant in
adolescents and toddlers (76.7% and 54.5% respectively),
while males were predominant in school age and preschool
age groups (72.9% and 64.9% respectively).
Stranger persons were the most frequent perpetrator of
child sexual abuse (381 cases, 46.9%) of both genders of
the victims (158 cases, 36.8% in females and 223 cases,
58.1% in males). Anal injuries were evident in 15% of
victims of child sexual abuse (122 cases). Acute anal
injuries were more frequent than chronic injuries (10.1%,
82 cases vs. 4.9%, 40 cases). There was significant
increase in frequency of acute anal injury in male victims
(17.7%, 68 cases) in comparison to that in female victims
(3.3%, 14 cases).The greatest frequency of vaginal injuries (both acute
and chronic) was in adolescents group (36.8%, 110 cases)
while there was no cases with vaginal injures in toddlers
group. The greatest frequency of acute vaginal injuries was
found in victims of child sexual abuse by stranger persons
(55.6%, 15 cases) while the greatest frequency of chronic
vaginal injuries was found in victims of sexual abuse by
adults friends (51.8%, 45 cases).
There was concomitant physical violence with sexual
abuse in 14.9% of victims of sexual abuse (evidenced by
wounds), contusions were the most common type of wound
and limbs were the most common body areas affected by
physical injuries.