medicolegal study of sexual offences in Dakahlia governorate

ABSTRACT

Sexual crimes are complex and multidimensional, over the past decade there has been an increase in and awareness of the sexual assaults especially the child sexual Abuse. It is difficult to estimate the true incidence of sexual assaults in both sexes. Retrospective study [from 1996-1999 years] and prospective study [during the year 2000] of 650 cases of sexual assaults of both sexes [their ages ranged from less than one year to 48 years] were examined in Forensic Medicine Administration of El-Mansoura during the period from 1996-2000. Females were exposed to sexual assaults more than males [the ratio was 32 respectively]. 62.6% of all victims aged from less than one year to 15 years and most of them were males. While 3 7.4% of victims were above 15 years and most of them were females. The highest percentages of offences referred from large cities [Mansoura 30.9% and Talkha 11.1%]. Illiterate [25.5%] and low educated [44.3%]victims were highly exposed to sexual assault more than other levels. Single females were more exposed to sexual assaults [91.6%] than others [married women, widows and divorced]. Invalid consent was recorded in 49.3% of 150 cases studied during the year 2000. While valid consent represented 6.0% of them. Through the 5 years study, 436 cases [67.1%] of 650 victims of sexual assaults know the assailant [membership, friendship, work related, lovers and neighbors]. Among these cases 28 [4.3%] were assaulted by their fathers, 5. [0.9%] by their brothers and 3 [0.5%] by their uncles. Whereas, in 214 cases [32.9], the assailants were strangers. The most common places that the sexual assault occurred was the assailant's house or workshop[when the victim worked with the assailant], victim's house, fields, desert places, folds, and cars. Signs of general violence [abrasions, contusions, and bite marks] were evident only in 14.6% of 650 victims, whereas in 85.4% of cases there was no evident signs of general violence. Manual force was applied in 22 victims [14.7%] and knives were used in 17 [11.3%] cases. Local findings on the genitalia were present in 253 cases [64.1%] of total 395 female victims. The most common was hymenal tears [recent and/or old] in 204 cases [51.6%]. Other signs included vulval bruises in 7 cases [1.8%], perineal tears in 2 cases [0.5%] and signs of frequent intercourse [eroded hymenal edges, remnant hymen, roomy vagina, smooth vaginal walls] in 33 cases [8.4%]. Local anal findings were recorded in 33.5% of 650 cases of both sexes. These findings included anal bruises, anal clefts, abrasions, and signs of frequent abuse. Positive results of clothes examination for blood and/or semen was recorded in 117 cases [18.0%], while negative results were recorded in 409 of cases and in 127 cases [19.5%] the examination of clothes for blood or semen was not performed. In the studied 395 total female cases throughout the 5 years, only 17 case [4.3%] gave positive vaginal swab for semen. And only one rectal swab [0.2%] was positive for semen 14 hours after the assault. The incidence of pregnancy among assaulted 323 fertile females was 37 [9.4%] cases and no positive results of sexually transmitted diseases were recorded