Child abuse and neglect as seen in a tertiary hospital in western Kenya: paediatricians’ perspective

Abstract

Background: Child abuse is defined as denying a child his or her rights such as food, clothing, education, health and emotional support. The forms of child abuse include physical, sexual, emotional, nutritional, child labour and abandonment. Objective: To describe the types of child abuse seen among the children admitted to the Moi Teaching and Referral Hospital (MTRH) paediatric wards. Design: Cross-sectional descriptive study. Setting: Moi Teaching and Referral Hospital wards in Eldoret. Subjects: Children aged below 18 years with suspected features of child abuse. Results: Of 119 children studied, 67(56.3%) were female. Types of abuse were: nutritional 65(39%) neglect 44(26.4%), abandonment 35(21%), physical 13(7.8%) and sexual 10(6%). Presenting complaints were gastroenteritis 46(38.7%), abandoned 31(26.1%) cough 29(24.4%) and burns 12(10.1%). Common clinical signs of abuse seen were malnutrition 63(52.9%), apathy 23(19.3%), and burns 13(10.9%), while 20(16.8%) had no signs of abuse. Factors significantly associated with: nutritional abuse were perpetrator being father 3.18(1.31, 7.69 p=0.009l), perpetrator being mother 3.00(1.27, 7.10 p=0.0112), neglect were alcoholic father 0.25(0.08, 0.73 p=0.0100), apathetic child 4.33(1.65, 11.34 p=0.0018), severe infection in the child 5.34(2.23,12.75 p=0.0001), Conclusions: The most common form of abuse seen was nutritional abuse. Most children presented with common childhood illnesses. Fathers were the predominant perpetrators of nutritional abuse and neglect. We recommend routine screening of children for features of abuse.