**8. Limitations**

The data was not obtained in a research setting but in a clinic setting where the workers are busy with managing acute cases. Lack of adequate human and material resources led to

Risk Factors in Sexually Abused

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#### **9. Acknowledgment**

We acknowledge the courage of the young children and their caregivers who came to University Teaching Hospital One Stop Centre.

I would like to thank the Centre for Disease Control and Prevention (CDC) Zambia for funding the establishment of the One Stop Centre at UTH. Also I would like to thank the following people for their efforts in the collection and gathering of information that was used for this chapter:

Mr. Elson Chama Mr. Katai Chola Ms. Mafunase Mako

Special thanks are also extended to:

Dr. Lackson Kasonka Managing Director UTH, Dr. Chipepo Kankasa Director Paediatric Centre of Excellence, Dr. Jonathan Mwansa Paediatrician, Mr. Kabanda Sampa OSC Clinic Coordinator and all the OSC Staff.

#### **10. References**

Agence France-Press 2003, Sexual Abuse of young girls rife in Zambia 29th September 2003


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Dr. Lackson Kasonka Managing Director UTH, Dr. Chipepo Kankasa Director Paediatric Centre of Excellence, Dr. Jonathan Mwansa Paediatrician, Mr. Kabanda Sampa OSC Clinic

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population lives.

**9. Acknowledgment** 

used for this chapter:

Special thanks are also extended to:

Coordinator and all the OSC Staff.

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**10. References** 

University Teaching Hospital One Stop Centre.


**8** 

**How Do We Recognize Recent Sexual** 

**What Is the Role of Paediatric Wards?** 

*Clinique Médicale Pédiatrique, UAED,* 

*CHU Nantes,* 

*France* 

**Abuse in Children Less than 10 Years of Age?** 

A diagnosis of sexual abuse in children is being made increasingly in France and in all Western countries. Sexual abuses in France represent a third of all cases of maltreatment 1. In children less than 10 years of age, discovery of the circumstances varies according to the situations experienced by the adolescents. Stories can involve silence or a revelation by indirect signs or consequences of abuses. To approach this diagnosis, we will successively address three aspects: the usual circumstances of the revelation or evocation of this diagnosis, a speech and behavioral side, and a clinical examination and its

Generally, children under the age of 10 years are brought by their parents, and come more

A child's speech or a sudden change in behavior could disturb the relatives [2]. The diagnosis can be done in an environmental context of sexual assault: the revelation of a sibling or the child himself. It sometimes involves an investigation around an abuser or

The evocation in less than three years old chidren may revolve around a child-minder, represented by doubt concerning behavioral or clinical abnormalities after returning home following a child-minding period, or more frequently, a situation evoking suspicion in the

The diagnosis can be sought in circumstances of clinical abnormalities discovered by the parents or physician, as represented by suspicious perineal lesions or the consequences of

The American Academy of Pediatrics established several factors which may lead to

sexual assault such as sexually transmitted disease atypical for the child's age [5].

**1. Introduction** 

difficulties.

**2. Circumstances** 

rarely with a social worker or forensic expertise.

abnormal behavior of parents [2-3-4-5].

suspicion of sexual assault in children 7:

context of parental separation [6].

**Experience in a French Paediatric Hospital** 

G. Picherot, N. Vabres, J. Fleury, E. Launay and C. Gras-Leguen

WHO. Preventing child maltreatment: a guide to taking action and generating evidence. In: *WHO-ISPCAN*, ed. Geneva, 2006 Zambia Health Demographics Survey 2007
