title: Physical and sexual abuse in orphaned compared to non-orphaned children in sub-Saharan Africa: a systematic review and meta-analysis.
abstract: This systematic review assessed the quantitative literature to determine whether orphans are more likely to experience physical and/or sexual abuse compared to non-orphans in sub-Saharan Africa (SSA). It also evaluated the quality of evidence and identified research gaps. Our search identified 10 studies, all published after 2005, from Zimbabwe, South Africa, Kenya and Uganda. The studies consisted of a total 17,336 participants (51% female and 58% non-orphans). Of those classified as orphans (n=7,315), 73% were single orphans, and 27% were double orphans. The majority of single orphans were paternal orphans (74%). Quality assessment revealed significant variability in the quality of the studies, although most scored higher for general design than dimensions specific to the domain of orphans and abuse. Combined estimates of data suggested that, compared to non-orphans, orphans are not more likely to experience physical abuse (combined OR=0.96, 95% CI [0.79, 1.16]) or sexual abuse (combined OR=1.25, 95% CI [0.88, 1.78]). These data suggest that orphans are not systematically at higher risk of experiencing physical or sexual abuse compared to non-orphans in sub-Saharan Africa. However, because of inconsistent quality of data and reporting, these findings should be interpreted with caution. Several recommendations are made for improving data quality and reporting consistency on this important issue.
authors.affiliation: University of Toronto, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada M5T 3M7.
authors.forename: J
authors.initials: J
authors.lastname: Nichols
authors.affiliation: Moi University, College of Health Sciences, School of Medicine, P.O. Box 4606, 0301000 Eldoret, Kenya.
authors.forename: L
authors.initials: L
authors.lastname: Embleton
authors.affiliation: Moi University, College of Health Sciences, Department of Behavioral Sciences, P.O. Box 4606, 0301000 Eldoret, Kenya.
authors.forename: A
authors.initials: A
authors.lastname: Mwangi
authors.affiliation: McGill University, Department of Pediatrics, 2300 Tupper, Montreal, Quebec, Canada H3H 1P3.
authors.forename: G
authors.initials: G
authors.lastname: Morantz
authors.affiliation: Moi University, College of Health Sciences, School of Medicine, Department of Child Health and Paediatrics, P.O. Box 4606, 0301000 Eldoret, Kenya; Indiana University, School of Medicine, Department of Pediatrics, 410 West 10th Street, Suite 1000, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., 410 West 10th Street, Indianapolis, IN 46202-3012, USA.
authors.forename: R
authors.initials: R
authors.lastname: Vreeman
authors.affiliation: Moi University, College of Health Sciences, School of Medicine, Department of Child Health and Paediatrics, P.O. Box 4606, 0301000 Eldoret, Kenya.
authors.forename: S
authors.initials: S
authors.lastname: Ayaya
authors.affiliation: Moi University, College of Health Sciences, School of Medicine, P.O. Box 4606, 0301000 Eldoret, Kenya.
authors.forename: D
authors.initials: D
authors.lastname: Ayuku
authors.affiliation: University of Toronto, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada M5T 3M7; Moi University, College of Health Sciences, School of Medicine, Department of Medicine, P.O. Box 4606, 0301000 Eldoret, Kenya; Indiana University, School of Medicine, Department of Medicine, 1001 West 10th Street, OPW M200, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., 410 West 10th Street, Indianapolis, IN 46202-3012, USA.
authors.forename: P
authors.initials: P
authors.lastname: Braitstein
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data*; D054540:Child, Orphaned / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D012107:Research Design; D012307:Risk Factors
keywords: Abuse; Orphans; Physical abuse; Sexual abuse; Sub-Saharan Africa; Systematic review