title: Domestic violence against children and adolescents: a challenge.
abstract: OBJECTIVE
  To study children and adolescents victims of domestic violence treated at the Referenced Pediatric Emergency Unit of the Hospital de Clínicas of the Universidade Estadual de Campinas and its specialized outpatient clinic between January 2003 and December 2007, emphasizing sexual abuse.
  
  
  METHODS
  The variables gender, age, origin, and classification were studied. For victims of sexual abuse, the following variables were also studied: type of abuse (rape), location (domestic/urban), duration (acute/chronic), perpetrator (known, incestuous), alterations at medical examination, notification to child protection agencies, and antiretroviral medication and serology (HIV, syphilis, hepatitis B and C). Patients were divided into two groups according to the type of abuse and type of perpertrator and they were associated with gender, age, and duration. For the comparison, chi-squared or Fisher's exact test were performed (significance p < 0.05), as well as raw prevalence odds ratio.
  
  
  RESULTS
  Of the total cases of abuse (551), neglect (33.9%) and sexual abuse (31.9%) predominated; the victims were female in 55.9% of the cases, and 50% were up to 5 years of age. Of the sexual abuse cases (95), 80% were female, and 58.9% were between 5 and 10 years of age. Rape was observed in 39% and indecent assault in 59.6%; 72.6% occurred in the domestic area, 81.1% by known perpetrator; 31.6% were incestuous, 47.4% were chronic, and 76.5% had no clinical alterations. 81.1% were referred to child protection agencies. Antiretroviral medication was prescribed to 49.1% of patients, and serological tests (HIV in 46 [48.4%], syphilis in 42 [44.2%], hepatitis B in 44 [46.3%] and hepatitis C in 45 [47.4%]%), all of which were negative, were more frequent in rape victims (p = 0.00). There was an association between rape and age (10 and 15 years, p = 0.01) and between incestuous perpetrator and chronic duration (p = 0.01).
  
  
  CONCLUSIONS
  Although this study does not reflect reality, it can be used as a warning to pediatricians.
authors.affiliation: Departamento de Pediatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, SP, Brasil. 　mzambon@fcm.unicamp.br
authors.forename: Mariana Porto
authors.initials: MP
authors.lastname: Zambon
authors.forename: Antonio Carvalho de Ávila
authors.initials: AC
authors.lastname: Jacintho
authors.forename: Michelle Marchi de
authors.initials: MM
authors.lastname: Medeiros
authors.forename: Rachel
authors.initials: R
authors.lastname: Guglielminetti
authors.forename: Denise Barbieri
authors.initials: DB
authors.lastname: Marmo
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000367:Age Factors; D000553:Ambulatory Care / Q000706:statistics & numerical data; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D002675:Child, Preschool; D017579:Domestic Violence / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis; D006801:Humans; D007179:Incest / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D015995:Prevalence; D011902:Rape / Q000706:statistics & numerical data; D012737:Sex Factors