Objective: The purpose of this study was to determine the importance of sexual abuse in young children with sexually transmitted diseases (STD) in Lomé (Togo).
Methods: This transversal study consisted of documenting all cases of STD in young children (up to 11 years of age) diagnosed during 20 months (May 1997 to December 1998) in the dermatovenereology unit of the Lomé teaching hospital. Syphilitic (TPHA-VDRL) and HIV serologies were carried out in all children. These serologies were repeated two weeks and three months later in sexually abused children.
Results: During this period, 33 cases of STD were diagnosed. There were 16 cases of anogenital warts (13 females, three males; mean age: 5.6 +/- 2.4 years); 13 cases of gonorrhoea (all were females; mean age: 7.2 +/- 1.8 years); and four cases of genital trichomoniasis (four females; mean age: 6.2 years). In 12 of 13 cases of gonorrhoea, sexual abuse was noted with identification of the alleged contaminators in ten cases. In eight of 16 cases of anogenital warts (all observed in females; mean age: 6.1 +/- 1.9 years), and two of four cases of genital trichomoniasis (mean age: six years) sexual abuse was observed. Syphilitic serology was negative in all children, but one ten-year-old girl had HIV infection with identification of the alleged contaminator.
Conclusion: The results of this study confirm that sexual abuse in children is not uncommon in black Africa and that the STD, like condylomata acuminata and gonorrhoea, are good indicators of this phenomenon. The classical consequences of such sexual abuses are aggravated in Africa by the high prevalence of HIV infection observed in the majority of countries, mainly in urban areas.