Analysis of demographics, examination findings and the social circumstances of paediatric sexual assault cases at a public hospital in Saint Lucia.

INTRODUCTION

Child sexual assault (CSA) complainants face profound emotional pain. Sexual assault (SA) is often underreported for several reasons. Furthermore, delays in the reporting increase the difficulty in confirming its occurrence. CSA profiles are affected by demographics, social culture and institutional factors.

OBJECTIVE

This study aimed to determine the prevalence, demographics, examination and social circumstances of CSA cases referred at a public hospital in Saint Lucia.

METHOD: A retrospective study was conducted which examined the demographics, examination findings and social circumstances of CSA complainants referred to the paediatric department between July 01, 2021, and June 30, 2023.

RESULTS

There were 67 complainants of CSA analysed with a prevalence of 14.6 unique cases/1000 Emergency Room paediatric visits. There was a female predominance of 65 (97.0 %) complainants. The main age group of CSA cases affected occurred mainly in the 11-15 age group (59.7 %), mostly by a known perpetrator (73.1 %) i.e. a neighbour (44.9 %). The younger the complainant (0-5 years), the shorter the interval from incident to medical evaluation compared to older complainants (p-value <0.05). Genitourinary signs of trauma were notable when medically examined within the first 14 days.

CONCLUSION

CSA was more prominent in female adolescents (11-15 years), and often done by a known perpetrator. Medical evaluation was delayed in the older age groups. Signs of genitourinary trauma were not always found on examination, and therefore forensic investigations for DNA will need to support the evidence in CSA cases.