[Chlamydia trachomatis and Neisseria gonorrhoeae infections in sexually abused children in Jutland].
BACKGROUND
At the Department of Forensic Medicine, University of Aarhus, Denmark, examinations are performed of children who are suspected of having been sexually abused. The medical forensic investigation aims at documenting sexual abuse if there are any physical findings. The presence of certain sexually transmitted diseases, which cannot be explained otherwise, may be such documentation. This article focuses on Chlamydia trachomatis and Neisseria gonorrhoeae, and the risk for the sexually abused child to contract these diseases.


METHODS
Retrospectively, we went through the Institute's files from 1996 to 2000 concerning child abuse. Information about age, sex, cultures for Chlamydia trachomatis and for Neisseria gonorrhoeae, and the results of these cultures was registered. If the child had been cultured, the suspected perpetrator's age and gender were registered as well. The children were all between 0 and 15 years of age, and in all cases the suspicion of sexual abuse had led to reporting to the police.


RESULTS
295 girls and 41 boys were examined in the period from 1996 to 2000. A total of 100 cultures for Chlamydia trachomatis and 105 cultures for Neisseria gonorrhoeae were performed. Among the 111 children who were examined for Chlamydia trachomatis and/or Neisseria gonorrhoeae there were no positive results. In 102 cases the suspected perpetrator was known to be one or more men, and only in one case it was a women. The mean age of the suspected perpetrators was 35.4 years.


CONCLUSIONS
The prevalence of Neisseria gonorrhoeae and Chlamydia trachomatis should reflect the prevalence in the group of perpetrators. Neisseria gonorrhoeae is uncommon outside Copenhagen, the capital of Denmark, whereas Chlamydia trachomatis is quite common. On this background, we had expected some of the children to be infected with Chlamydia trachomatis. Therefore, the risk for sexually abused children to be infected with Chlamydia trachomatis or Neisseria gonorrhoeae is very low, depending on the kind of abuse and the perpetrator's possible risk behaviour, age, and gender. As a conclusion, only children with a clear indication should be tested for these sexually transmitted diseases.
Nielsen
Lene Aagaard
LA
Retsmedicinsk Institut, Aarhus Universitet, Peter Sabroesgade 15, DK-8000 Arhus C.
Mikkelsen
Søren Johan
SJ
Charles
Annie Vesterby
AV
D000293:Adolescent; D000328:Adult; D002648:Child; D002650:Child Abuse, Sexual / Q000175:diagnosis; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000635:transmission*; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003718:Denmark; D005260:Female; D005554:Forensic Medicine; D006069:Gonorrhea / Q000635:transmission*; D006801:Humans; D007223:Infant; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D012189:Retrospective Studies