{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:26:16Z","timestamp":1785252376803,"version":"3.55.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2014,1,30]],"date-time":"2014-01-30T00:00:00Z","timestamp":1391040000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Children are vulnerable to abuse and violence because their level of development makes them unable to protect themselves. Such adversities during early childhood may have a negative impact on the future lives of the victims.<\/jats:p>\n            <jats:p>This study was done to determine the delay to hospital presentation, clinical manifestations and immediate health effects of child sexual abuse in two tertiary care hospitals in Ethiopia.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We reviewed records of all cases of child sexual and physical abuse between January 2011 and December 2012. Bivariate and multivariate logistic regression models were used to test the presence and strength of association between time to reporting to hospital and, age and sex of the victim, place of residence and relation of the victim to the perpetrator. Odds ratio and 95% confidence intervals were generated. Significance was taken as p-value\u2009&lt;\u20090.05.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>During the study period, we identified records of 275 children who were seen for alleged physical and sexual abuse; they accounted for 0.6% of the outpatient department (OPD) visits. The majority of the victims were cases of sexual abuse (97.3%) and most of them were female (75.7%). The mean age of the victims was 9.5\u00a0years (standard deviation (SD) =\u20094.2\u00a0years). The majority of the abusers were known to the victim (73.0%) and male (98.8%). Neighbors (38.95%), teachers (7.9%) and relatives (13.4%) were the most commonly reported perpetrators. The median length of time taken to present to hospital after the abuse incident was 4\u00a0days (range\u2009=\u20092\u00a0hours to 3\u00a0years). Male victims were 2.4 times more likely to have a delay of greater than one week to present to hospital (Adjusted Odds Ratio (AOR), 2.40; 95% Confidence interval (CI), 1.34-4.31; <jats:italic>P-value<\/jats:italic>\u2009=\u20090.002). Sexual abuse was associated with various immediate health effects, for example, hymenal tear, urinary tract infection and, perineal laceration or tear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Presentation for care was often delayed. Male sex was independently associated with a delayed presentation to care. We recommend that further studies are carried out to identify the reasons for delay to reporting and design mechanisms to address them.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2458-14-92","type":"journal-article","created":{"date-parts":[[2014,1,30]],"date-time":"2014-01-30T10:02:54Z","timestamp":1391076174000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Time to presentation, pattern and immediate health effects of alleged child sexual abuse at two tertiary hospitals in Addis Ababa, Ethiopia"],"prefix":"10.1186","volume":"14","author":[{"given":"Timketa","family":"Girgira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birkneh","family":"Tilahun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tigist","family":"Bacha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2014,1,30]]},"reference":[{"key":"6270_CR1","first-page":"121","volume-title":"Child Abuse and Neglect: Multidisciplinary approach (1st Ed)","year":"2000","unstructured":"Child Abuse and Neglect: Multidisciplinary approach (1st Ed). Edited by: Winton MA, Mara BA. 2000, New Jersey, USA: Pearson Education, 121-"},{"key":"6270_CR2","unstructured":"International Child Abuse Network (Yes I CAN): Definition of child abuse. http:\/\/www.yesican.org\/defined.html [Accessed on November 10, 2012]"},{"key":"6270_CR3","unstructured":"UNICEF: The state of the World\u2019s children: childhood under threat. Press release, December 2005. http:\/\/www.unicef.org\/publications\/files\/SOWC_2005_(English).pdf [Accessed on November 10, 2012]"},{"key":"6270_CR4","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1016\/S0140-6736(09)60247-6","volume":"373","author":"A Reza","year":"2009","unstructured":"Reza A, Breiding MJ, Gulaid J, Mercy JA, Blanton C, Mthethwa Z, et al: Sexual violence and its health consequences for female children in Swaziland: a cluster survey study. Lancet. 2009, 373: 1966-1972. 10.1016\/S0140-6736(09)60247-6.","journal-title":"Lancet"},{"key":"6270_CR5","doi-asserted-by":"publisher","first-page":"447","DOI":"10.2471\/BLT.07.047423","volume":"87","author":"DW Brown","year":"2009","unstructured":"Brown DW, Riley L, Butchart A, Meddings DR, Kann L, Harvey AP: Exposure to physical and sexual violence and adverse health behaviours in African children: results from the global school-based student health survey. Bull World Health Organ. 2009, 87: 447-455. 10.2471\/BLT.07.047423.","journal-title":"Bull World Health Organ"},{"key":"6270_CR6","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.chiabu.2003.07.005","volume":"28","author":"K Lalor","year":"2004","unstructured":"Lalor K: Child sexual abuse in sub-Saharan Africa: a literature review. Child Abuse Negl. 2004, 28: 439-460. 10.1016\/j.chiabu.2003.07.005.","journal-title":"Child Abuse Negl"},{"issue":"2","key":"6270_CR7","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1080\/00207594.2012.691975","volume":"48","author":"C Mbagaya","year":"2013","unstructured":"Mbagaya C, Oburu P, Bakermans-Kranenburg MJ: Child physical abuse and neglect in Kenya, Zambia and the Netherlands: a cross-cultural comparison of prevalence, psychopathological sequelae and mediation by PTSS. Int J Psychol. 2013, 48 (2): 95-107. 10.1080\/00207594.2012.691975.","journal-title":"Int J Psychol"},{"issue":"2","key":"6270_CR8","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1080\/00207594.2012.737467","volume":"48","author":"S Skeen","year":"2013","unstructured":"Skeen S, Tomlinson M: A public health approach to preventing child abuse in low- and middle-income countries: a call for action. Int J Psychol. 2013, 48 (2): 108-116. 10.1080\/00207594.2012.737467.","journal-title":"Int J Psychol"},{"issue":"3","key":"6270_CR9","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1258\/004947506777978325","volume":"36","author":"D Worku","year":"2006","unstructured":"Worku D, Gebremariam A, Jayalakshmi S: Child sexual abuse and its outcomes among high school students in southwest Ethiopia. Trop Doct. 2006, 36 (3): 137-140. 10.1258\/004947506777978325.","journal-title":"Trop Doct"},{"issue":"2","key":"6270_CR10","doi-asserted-by":"publisher","first-page":"80","DOI":"10.4314\/eamj.v78i2.9093","volume":"78","author":"Z Lakew","year":"2001","unstructured":"Lakew Z: Alleged cases of sexual assault reported to Two addis Ababa hospitals. East Afr Med J. 2001, 78 (2): 80-83.","journal-title":"East Afr Med J"},{"key":"6270_CR11","volume-title":"National action plan on sexual abuse and exploitation of children (2006\u20132010)","author":"Ministry of Labor and Social Affairs (MOLSA)","year":"2013","unstructured":"Ministry of Labor and Social Affairs (MOLSA): National action plan on sexual abuse and exploitation of children (2006\u20132010). 2013, Addis Ababa, Ethiopia: MOLSA"},{"issue":"1","key":"6270_CR12","first-page":"59","volume":"22","author":"J Jemal","year":"2012","unstructured":"Jemal J: The child sexual abuse epidemic in Addis Ababa: some reflections on reported incidents, psychosocial consequences and implications. Ethiop J Health Sci. 2012, 22 (1): 59-66.","journal-title":"Ethiop J Health Sci"},{"key":"6270_CR13","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/1472-698X-13-24","volume":"13","author":"RT Haile","year":"2013","unstructured":"Haile RT, Kebeta ND, Kassie GM: Prevalence of sexual abuse of male high school students in Addis Ababa, Ethiopia. BMC Int Health Hum Rights. 2013, 13: 24-10.1186\/1472-698X-13-24.","journal-title":"BMC Int Health Hum Rights"},{"key":"6270_CR14","first-page":"150","volume-title":"Nelson Text Book of Pediatrics","author":"RM Kleigman","year":"2011","unstructured":"Kleigman RM, Dubowitz H, Lane WG, et al: Sexual abuse. Nelson Text Book of Pediatrics. Edited by: Stanton BF, Geme JW, Schor NF, Behrman RE. 2011, Philadelphia PA, USA: Elsevier Saunders, 150-"},{"key":"6270_CR15","unstructured":"Corporal punishment of children in Ethiopia. Save the children (Sweden), Addis Ababa, Ethiopia, 2011. Available at: http:\/\/resourcecentre.savethechildren.se\/sites\/default\/files\/documents\/6743.pdf,"},{"issue":"4","key":"6270_CR16","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1016\/j.jgyn.2007.11.002","volume":"37","author":"DME Faye","year":"2008","unstructured":"Faye DME, Traore AL, Gueye SM, Moreira PM, Diouf A, Moreau JC: Sexual abuse: epidemiological, clinical aspects and management at gynaecological and obstetrical department of Dakar university hospital. J Gynecol Obstet Biol Reprod (Paris). 2008, 37 (4): 358-364. 10.1016\/j.jgyn.2007.11.002.","journal-title":"J Gynecol Obstet Biol Reprod (Paris)"},{"issue":"10","key":"6270_CR17","first-page":"950","volume":"97","author":"S Cox","year":"2007","unstructured":"Cox S, Andrade G, Lungelow D, Schloetelburg W, Rode H: The child rape epidemic: assessing the incidence at Red Cross Hospital, Cape Town, and establishing the need for a new national protocol. S Afr Med J. 2007, 97 (10): 950-955.","journal-title":"S Afr Med J"},{"issue":"2","key":"6270_CR18","doi-asserted-by":"publisher","first-page":"54","DOI":"10.4314\/mmj.v21i2.44550","volume":"21","author":"E Chesshyre","year":"2009","unstructured":"Chesshyre E, Molyneux EM: Presentation of child sexual abuse cases to queen Elizabeth central hospital following the establishment of an HIV post-exposure prophylaxis program. Malawi Med J. 2009, 21 (2): 54-58.","journal-title":"Malawi Med J"},{"issue":"4","key":"6270_CR19","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1891\/0886-6708.27.4.592","volume":"27","author":"S de Haas","year":"2012","unstructured":"de Haas S, van Berlo W, Bakker F, Vanwesenbeeck I: Prevalence and characteristics of sexual violence in the Netherlands, the risk of revictimization and pregnancy: results from a national population survey. Violence vict. 2012, 27 (4): 592-608. 10.1891\/0886-6708.27.4.592.","journal-title":"Violence vict"},{"issue":"7","key":"6270_CR20","first-page":"350","volume":"69","author":"RW Nduati","year":"1992","unstructured":"Nduati RW, Muita JW: Sexual abuse of children as seen at Kenyatta National Hospital. East Afr Med J. 1992, 69 (7): 350-354.","journal-title":"East Afr Med J"},{"issue":"1","key":"6270_CR21","first-page":"22","volume":"46","author":"OK Ige","year":"2012","unstructured":"Ige OK, Fawole OI: Evaluating the medical care of child sexual abuse victims in a general hospital in Ibadan, Nigeria. Ghana Med J. 2012, 46 (1): 22-26.","journal-title":"Ghana Med J"},{"issue":"1","key":"6270_CR22","first-page":"32","volume":"23","author":"A Hailye","year":"2013","unstructured":"Hailye A: Psychopathological correlates of child sexual abuse: the case of female students in jimma zone, south west Ethiopia. Ethiop J Health Sci. 2013, 23 (1): 32-37.","journal-title":"Ethiop J Health Sci"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-14-92.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2458-14-92\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-14-92","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-14-92.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T03:00:38Z","timestamp":1630551638000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/1471-2458-14-92"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,30]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,12]]}},"alternative-id":["6270"],"URL":"https:\/\/doi.org\/10.1186\/1471-2458-14-92","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1,30]]},"assertion":[{"value":"30 August 2013","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2014","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 January 2014","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"92"}}