Clinical presentation and management of alleged sexually assaulted females at Mulago Hospital, Kampala, Uganda

Abstract

Objective: To determine the presentation and treatment offered to sexually assaulted females attending emergency gynaecological ward in Mulago Hospital, Kampala, Uganda. Setting: Mulago Hospital Gynaecological emergency ward. Study design: Prospective descriptive study. Participants: Fifty eight sexually assaulted females were recruited from 1st March 2000 to 31st December 2000. They were interviewed, examined, given appropriate treatment and followed up for three months. Outcome variables: Socio-demographic characteristics, genital and bodily injuries, relationship to the assailant, and prevalence of sexually transmitted infections. Results: The mean age was 9.5 with a range of 1-35 years. Seventy two percent of the victims were children below 12 years. Fifty percent of the assault occurred at the assailant's home. The majority (79.3%) of the victims knew the assailant and cases of gang rape were only 6.9%. The injuries sustained were extra genital (19.0%), genital (75.4%). The emotional or psychological disturbance was present in 22.4% of the patients. The sexually transmitted infections found included trichomonas vaginalis (1.7%) and syphilis (3.7%). All cases received counseling and prophylactic treatment for sexually transmitted infections. Those in reproductive age group were offered emergency contraception. None of the victims got post exposure HIV therapy because it was not available in the hospital. Conclusion: Sexual assault is common in Uganda and is one of the most dehumanizing human crimes against women. It is associated with adverse medical and social problems. There is urgent need to sensitize the community about reporting early for medical treatment after sexual assault.