title: Child sexual abuse presenting to District General Hospital, Chilaw
abstract: Incidence of child sexual abuse is increasing
  worldwide. There is little data on child sexual abuse in
  the North Western Province of Sri Lanka.
  
  
  
  To describe the demographic and medico-legal
  findings of victims of sexual abuse aged less than 16 years
  and to identify factors associated with positive findings on
  medical-legal examination.
  
  
  
  This cross-sectional analytical study, analysed 132
  victims, referred by authorities to General Hospital,Chilaw,
  from 2012 to 2014.
  
  
  
  Mean age of the victims was 13.1years. Main types
  abuse were penetrative (61.4%), intra-crural (39.4%) and
  anal sex (10.6%). The perpetrator was known in 94%. Places
  of offence were offender’s habitat (55.3%), victim's home
  (23.5%) and secluded areas (11.4%). A positive history of
  penetrative sex (OR =15.3; 95% CI 5.6-42), chronic sexual
  abuse (OR=4.8; 95% CI 2.2-10.5) and time lapse in reporting
  to authorities (OR=4.4; 95% CI 2.0-9.4) were significantly
  associated with presence of conclusive medical
  examinations findings. Children were less likely to be willing
  partners in intra-familial abuse compared to extra-familial
  abuse where the child was sometimes a willing partner,
  (OR=0.2; 95% CI 0.07-0.5). Adverse psychological
  outcomes were observed in 16.7% (n=22).
  
  
  
  Most children were victims of statutory rape and
  knew the perpetrator. In extra-familial abuse, child was
  sometimes a willing partner. A positive history of
  penetrative sex, number of abusive incidents and time
  lapse for presentation were important factors
  associated with conclusive medical findings.
authors.affiliation: Obstetrics and Gynaecology Unit, District General Hospital, Chilaw,Sri Lanka. manojdc1980329@gmail.com
authors.forename: M D
authors.initials: MD
authors.lastname: Chandrasiri
authors.forename: D K
authors.initials: DK
authors.lastname: Wijewardena
authors.forename: S D
authors.initials: SD
authors.lastname: Lanerolle
authors.forename: S E
authors.initials: SE
authors.lastname: Chandrasiri
authors.forename: K P
authors.initials: KP
authors.lastname: Wijewardena
authors.forename: R T
authors.initials: RT
authors.lastname: Cooray