Child sexual abuse in Zaria, Northwestern Nigeria

Background: Child sexual abuse has been reported from all corners of the globe, and all age groups and both sexes are affected. Although the trauma of abuse heals with time, it leaves long term psychological and medical problems. This study was aimed at documenting the pattern of child sexual abuse in Zaria, Northern Nigeria. Methods: Retrospective study of case notes of all patients seen with a history of sexual abuse, from August 2008 to October 2009, at a primary health centre in Northwestern Nigeria. Results: A total of twenty cases were seen out of a total of 33, 313, which gave a prevalence rate of 0.06%. There were three boys and 17 girls, with a male: female ratio of 1: 5.7. The age range was 3-13 years, with a mode of 7years. Majority (19, 95%) were aged 12 years and below. Eleven cases (55%) attended school, while three (15%) were hawkers. Twelve (60%) of the children presented more than 72 hours after the assault. Twelve (60%) cases were abused more than once, and there was evidence of genital trauma in 60% of cases. The assailants were all males, and identified in 70% of the cases. Of those identified, 55% of them had previously been suspected of committing sexual abuse. In 55% of cases the assailants were either household members or neighbours. Only 12 (60%) of incidents were reported to the police. Legal outcome was not known in any of the cases. All the cases defaulted to follow-up. Conclusion: Child sexual abuse is not an uncommon problem in Zaria. There is a need to ensure follow-up after treating immediate medical problems, in order to manage and prevent the long-term psychological problems of sexual abuse. The high default rate to follow-up needs to be further investigated. The legal outcome in all the cases was unknown.