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718 The nationwide survey of child and sexually abuse in Thailand
  1. Orawin Vallipakorn1,
  2. Sakda Arj-ong Vallipakorn2,3,
  3. Adisak Plitponkarnpim3,4
  1. 1Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  2. 2Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  3. 3Child Safety Promotion and Injury Prevention Research Centre (CSIP), Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  4. 4Department of Paediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400

Abstract

Background Child abuse was top five rank causes of preventable premature death in Thai children. Many types of child injury were reported by campaign/law enforcement and nationwide policy such transport injury and other physical injuries (drowning and near drowning, falling, suffocation, bite and string, burn and struck by against). Child Abuse and maltreatment was a one problem of injury types that difficult to report and approach. As a tip of iceberg, a few cases were reported and usually fatal but these bring to the short term of social concern due to few evidence. Finally there were not strategies to improve and cope with this problem.

Methods The National Injury Database (NPIRT) was developed and implemented. It included all types of injured children participated from 34 emergency services across country during 2010–2012 to solved this problem. The descriptive analytic of child injury surveillance such as age group, sex, pre-hospital factors and support, vital signs, GCS, mechanism and type of injuries included with child abuse components and outcome were included in this new database and analysed.

Results Of these 42,144 cases from NPIRT, The mainly interest was the incidence of child abuses that occurred 2,400 cases (5.7%), Male: Female 1.4: 1 and mean age 15.3 + 3.32 years. The death rate of child abuse was higher in male than female (1:100). 92% of children were injured mainly within their residential areas. Only two-third of abuse was transferred by ambulance. About 37% had prior communication with the referral hospitals and healthcare worker before transportation. 34% of children had initial first aid at scene and 29% were provided appropriately. The mainly mechanism of all child abuses were physical blunt injury (51%) followed by penetrating (5%). Most of common injuries were physical abuse (2,309 cases, 95%), and following with sexually abused (91 cases, 5%). The overall child abused death was 9 per 1,000 victims.

Conclusions The NPIRT included with child abuse information was provided as the nationwide comprehensive injury database of Thailand. It was a useful tool to identify the incidence all of death in Thai injured children. It can explore the causes of injury child death integrated with child abuse and child maltreatment information, especially sexually abuse and their association factors and high risk of injury mechanism that can incorporate to future preventive strategy.

  • Child abuse
  • Child maltreatment
  • Sexual abuse
  • Injury database

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