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Does sexually transmitted infection always mean sexual abuse in young children
Sexually transmitted infections are an uncommon but recognised consequence of sexual abuse among young children. There is agreed guidance for assessment and management. Reading and colleagues report the incidence, mode of presentation, investigation and child protection procedures in children under between age 1 and 12 years presenting with common (non viral) sexually transmitted infections (British Paediatric Surveillance Unit, 25 months, 2010–12). Fifteen cases were reported—Gonorrhoea (7), Syphilis (1), Chlamydia (6), Trichonomas (1). This gives an overall incidence of 0.075 cases per 100,000 per year. Five cases presented with ophthalmic infection. Sexual abuse was confirmed in three by court or case conference and was suspected in a further seven children. Most cases were identified following symptomatic presentation. In an accompanying editorial Patrick Kelly discusses the data suggesting that the incidence may be an underestimate as the following assumptions were made to calculate—children with genital symptoms were brought for medical contact, their symptoms were adequately assessed, samples were taken and processed correctly and positive samples were notified to a paediatrician and the surveillance unit. He also addresses in some depth the emotive question—Does sexually transmitted infection always mean sexual abuse in young children—essential reading for paediatricians. See pages 712 …
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