Fatal physical child abuse in two children of a family

Non-Accidental Injuries in Pediatric Primary Care: A Systematic Literature Review of Objective Assessment Tools and Trends in Gulf Cooperation Council Region

Nonaccidental injuries (NAI) in pediatric primary care in the Gulf Cooperation Council (GCC) region refer to intentional injuries inflicted on children, usually by a caregiver or a family member. The region has seen an increase in nonaccidental injuries in recent years, and healthcare providers have a crucial role in identifying and managing the cases. The aim of research on nonaccidental injuries in pediatric primary care in the GCC region is to identify objective assessment tools and evaluate trends in the region. PubMed, Google Scholar, and EMBASE databases were searched using search string keywords. The search was conducted on 7^th February 2023. The keywords included in the search included the search terms: nonaccidental injuries, pediatric, and GCC. All the studies were published between 1990 and 2023. The articles that passed the eligibility criteria were read fully to examine whether they would be relevant to the current systematic literature review. An initial search identified 3059 studies (Google Scholar = 6, EMBASE =12, PubMed = 4732). After the deletion of similar articles, only 3613 articles were left for further screening. The abstracts and titles of the left articles were scanned and screened to decide whether they were included in this systematic review. After deletion, 16 papers were inspected and read fully based on predefined eligibility criteria. Eventually, 11 papers were recognized and identified that passed the eligibility criteria of this systematic review. The studies reviewed in this analysis highlight the significant problem of child abuse in the GCC region, particularly neglect as the most common form of abuse. The studies also suggest that parents are the most frequent perpetrators of abuse. The need for policies and interventions to prevent child abuse and support victims is paramount.

Physical Child Abuse by Parents and Teachers in Saudi Arabia: a Systematic Literature Review

A systematic review was conducted to find out what is known about the prevalence and nature of physical child abuse in Saudi. The review identified 15 abuse prevalence studies carried out in Saudi Arabia between 1998 and 2016, written in English or Arabic. An analysis of these revealed the known prevalence of different types of child abuse, the relationship of the abuser to the victim, and the level of awareness among school professionals of procedures and programs in Saudi to protect children from abuse. The review revealed many shortcomings of existing literature, including a paucity of published studies, lack of rigor in research design, an absence of data from many parts of the country, and an emphasis on hospital reports rather than data collected directly from victims. Studies conducted to date suggest that physical abuse of children is more widespread and severe in the Kingdom than previously acknowledged.

International issues in abusive head trauma

In the decades since Dr. John Caffey described a series of children with chronic subdural hematoma and long bone fractures, there has been a substantial increase in the medical recognition of various forms child abuse. In the United States, the term shaken baby syndrome was coined to explain a constellation of injuries assumed to be the result of violent shaking of infants. After improved understanding of the variety of mechanisms that occur when children are abused, abusive head trauma (AHT) has become the recommended terminology. AHT is a more comprehensive term that reflects the brain injuries that children suffer as the result of abuse. AHT continues to include shaking as a mechanism of injury as well as shaking with impact, impact alone, crushing injuries or combinations of several mechanisms. The medical community in the United States has led the way in developing new terminology and research to describe this unique and devastating form of abuse. The globalization of medicine and rapid information transfer has resulted in AHT becoming well-recognized internationally as a form of serious and fatal child abuse. This paper will review the historical basis in the United States for the diagnosis of AHT. We will also review some of the current international issue in epidemiology, diagnosis, legal processes and outcomes in selected countries/regions where child abuse physicians are actively involved in the evaluation of AHT.

Preventing child abuse and neglect in Saudi Arabia: are we ready?

Although child abuse and neglect (CAN) have been recognized by medical professionals for the last 20 years, child protection services and child maltreatment prevention programs are still emerging in Saudi Arabia. This paper will review the progress made in the country in terms of recognition and implementation of child protection services. Furthermore, it will draw attention to the essential steps required to start child maltreatment prevention programs, as CAN prevention is currently viewed as a global healthcare priority with an emphasis on evidence-based interventions. In addition, this paper will assess Saudi Arabia's readiness to prevent CAN and the challenges that will be faced by the professionals in implementing evidence-based CAN prevention programs.

Child abuse and neglect in Saudi Arabia: journey of recognition to implementation of national prevention strategies

OBJECTIVES

To describe increased child abuse and neglect (CAN) reporting and the characteristics of the reports in the context of the development of a system of intervention for one of the hospital-based child protection centers in Riyadh, Saudi Arabia aligned with the United Nations Convention on the Rights of the Child (CRC) Article 19.

METHODS

A retroprospective collection of data on all children evaluated by the Suspected Child Abuse and Neglect (SCAN) team in King Abdulaziz Medical City for the National Guard from 2000 to 2008. The cases were further divided into 3 subgroups corresponding to the years 2000-2004, 2005-2006, and 2007-2008 parallel to the stages of development of the national child protection system.

RESULTS

During the study period, there were a total of 188 referrals to the SCAN team. Of these 133 (70.7%) were further investigated as CAN cases. The total number of referred cases increased 10-fold from 6.4 cases per year in the first period to 61.5 cases per year in the third period. The mean age was 5 years, evenly represented by males and females. Physical abuse was the most common form of abuse in the first (2000-2004) period at 61% and second (2005-2006) period at 76%, which changed to neglect (41.6%) as the most common form of maltreatment in the third (2007-2008) period. Parents were the perpetrators in 48.9% of cases throughout the 3 periods. Overall fatality rates were 4.4%, 14.3%, and 7.9% in the first, second, and third periods respectively.

CONCLUSION

Recognition of CAN is expanding in Saudi Arabia. This is due to the successful adoption of a system of intervention consisting of child protection centers in the medical facilities, in conjunction with mandatory reporting and data collection strategies. In addition, the changes in public attitudes towards a better understanding of CAN enhanced further recognition and reporting of neglect and milder forms of abuse. We believe that the number of reported CAN cases in Saudi Arabia will continue to rise, hence adequate multi-sectoral services for the abuse victims require further development and improvements throughout the country.

Socio-demographic correlates of psychiatric morbidity among low-income women in Aleppo, Syria

Interest in mental morbidity as an important component of health is increasing worldwide. Women generally suffer more than men from common mental disorders, and discrimination against women adds to their mental sufferings. Studies looking into the socio-demographic correlates of women's mental morbidity are lacking in most Arab countries. In this study we wanted to determine the spread and socio-demographic correlates of mental distress among low-income women in Aleppo, Syria. A sample of 412 women was recruited from 8 randomly selected primary care centers in Aleppo. Response rate was 97.2%, mean age of participants 28 + 8.4 years, where married women constituted 87.9%. A special questionnaire was prepared for the study purpose, utilizing the SRQ-20 non-psychotic items and questions about background information considered relevant to the mental health of women in the studied population. Interviews were conducted in an anonymous one-to-one fashion. The prevalence of psychiatric distress in our sample was 55.6%. Predictors of women's mental health in the logistic regression analysis were; physical abuse, women's education, polygamy, residence, age and age of marriage. Among these predictors, women's illiteracy, polygamy and physical abuse were the strongest determinants of mental distress leading to the worse outcomes. Our data show that mental distress is common in the studied population and that it is strongly associated with few, possibly modifiable, factors.