[Sexual abuse in Ziguinchor, Senegal: epidemiology and management]

To determine the frequency of sexual abuse, establish the demographic profile and to evaluate the care of victims of sexual abuse in Ziguinchor.

That is a retrospective, descriptive study from February 1, 2008 to August 31, 2010, including all patients received in the Department of Gynecology and Obstetrics, Ziguinchor Regional hospital for sexual abuse. For each patient, data analyzed were sociodemographic data, characteristics of aggression, clinical implications and psychological support. The data were entered and analyzed using the Excel 2003 version.

50 cases of sexual abuse were collected on 4950 patients, a prevalence of 1%. The average age of victims was 13 years (range: 3 to 23 years). The abuse took place in the day in 60% of cases. The location was familiar to victims in 70% of cases. The notion of penetrative genital contact was reported in 74% of victims. Physical force or a weapon was used in 34% of cases. The offender was 30 years old in 86% and operated alone in 92% of cases. Half of the victims had consulted in the first 24 hours. Genital trauma was found in 82% of victims. Feelings of fear, shame, or anger was observed in 64% of patients. Antibiotic was prescribed in two-thirds of the victims as postexposure prophylaxis for HIV was performed in only five patients. Emergency contraception was prescribed in 34% of victims. Six pregnancies were recorded. Six patients had developed complications such as depressive syndrome, hysteria with severe epileptiform seizures, mood disorder and psychosis. A proportion of 26% of victims did not consider it necessary to have recourse to justice.

The management of a victim of sexual abuse should not stop at a forensic evaluation. We must therefore endeavor to provide a solution to three important consultation which are medical care, legal and emotional.