Causes, Spectrum and Effects of Surgical Child Abuse and Neglect in a Nigerian City

BACKGROUND: Children are dependent on parents/care givers for the quality of health care services received and in developing countries, where they are not protected against child abuse; many die as a result of denial of appropriate treatment. OBJECTIVE: The objective of this study was to determine the causes, spectrum and effects of abuse/neglect on surgical children. METHODS: Analysis of cases of surgical child abuse/neglect between January, 1998 and December, 2007 at the University of Benin Teaching Hospital, Benin City, Nigeria, was done. RESULTS: A total of 281 children aged two days and 12 years comprising 113 males and 168 females with male/female ratio 1:1.4, mainly with congenital malformation, suffered surgical child abuse/neglect ranging from delayed presentation, to child abandonment which was perpetuated by ignorance, poverty, superstitious beliefs, customs as well as non availability of free medical services for children. Counselling and home visits in addition to surgeries were done and 198 (70.5%) children were successfully treated with those abandoned happily reunited with their families, while 56 (19.9%) mortality was recorded due to complications of the primary surgical pathology, and this was statistically significant compared with other children with similar lesions but without abuse or neglect during the period (P=0.0102). Whereas 27 (9.6%) among those discharged against medical advice were lost to follow-up, of the 198 children that survived, 22 suffered psychological trauma and were co-managed with psychologists while seven were transferred to orphanage homes. CONCLUSION: Surgical child abuse/neglect is rampant, hence, it is hoped that these findings will influence policy makers in this sub-region to formulate policies that will protect children against this form of child abuse.