Апстракт
Child abuse is recognized globally as a major public health issue and in recent years, Nigerian communities have become increasingly aware of this problem. Numerous studies have revealed that the head and oro-facial region are common sites of trauma from child abuse. For this reason, dentists are in a strategic position to recognize and report suspected cases.The aim of the study is to assess the knowledge and attitudes of Nigerian dentists towards child abuse. A descriptive survey was conducted among 175 dentists in Nigeria. Results revealed that physical abuse, neglect and emotional abuse was recognized by 61.7%, 53.1% and 33.1% of the respondents respectively as forms of abuse. A greater proportion of the females (42.3%) in contrast to the males (26.9%) identified emotional abuse (p<0.05). Psychosocial, medical and oro-dental signs were associated with child abuse by 68.0%, 60% and 15.4% of the respondents respectively. More than a third (39.4%) of the dentists claimed to have suspected child abuse in one or more of their young patients however, only 6.9% had actually reported. The possible effects on the child, uncertainty about the diagnosis and fear of litigation were factors which 92%, 81.1% and 64.6% of the dentists respectively claimed could influence their decision to reporting child abuse.This study has demonstrated that some knowledge gaps exist among dentists in recognizing and reporting this problem. There is a need for further information and training at all levels of the dental profession in the recognition and reporting of child abuse.
Keywords: Child abuse, dentists, Nigeria.
Résumé
L’abus d’enfants est reconnu globalement comme un issue de santé publique majeure. Récemment les communautés Nigériane sont devenues plus sensibles à ce fléau. De nombreux études ont révélés que la tête et la région oro-faciale sont des sites commun du traumatisme du a l’abus d’enfants. Pour cette raison, les dentistes sont a une position stratégiques pour reconnaître et dénoncer les cas suspectés. Le but de cette étude est d’évaluer la connaissance et l’attitude des dentistes Nigérians envers les abus d’enfants. Une enquête descriptive était organisée parmis175 dentistes. Les résultats ont révélé que l’abus physique, la négligence et l’abus émotionnel étaient reconnu à 61.7%,53.1% et 33.1% respectivement des participants. La grande proportion des femelles (42.3%) en contraste avec les males (26.9%) identifiaient l’abus émotionnel (P<0.05). Les signes psychosocial, médical et oro dental étaient associées a l’abus des enfants par 68.0%,60% et 15.4% des participants respectivement. Plus du tiers (39.4%) des dentistes ont déclaré d avoir suspecté l’abus d’enfants chez la plupart des jeunes patients. Cependant seulement 6.9% ont actuellement reporté. Les effets possibles sur l’enfant, l’incertitude des diagnostiques et la peur des contentieux étaient des facteurs influençant le reportage chez les dentistes dans l’ordre de 92%,81.1% et 64.1% respectivement. Cette étude a démontré que quelques lacunes de connaissances existent parmi les dentistes dans la reconnaissance et le reportage de ce problème. Il y a un besion d’information suplementaires et de formation a tous les niveaux de la profession dentaire dans la reconnaissance et le reportage des abus d enfance.
Correspondence: Dr. O.O. Bankole, Department of Child Oral Health, College of Medicine, University College Hospital, Ibadan, Nigeria. Email: bumbank2002@yahoo.com
Референце
Ten Bensal RW, Rheinberger MM and Radbill SX. Children in a world of violence: the roots of child maltreatment. In Helfer ME, Kempe RS, Krugman RD, eds. The battered child. Chicago, IL, University of Chicago Press, 1997: 3-28.
Kempe CH, Silverman FN, Steele BB, Droegemueller W and Silver H K. The battered child syndrome. J Am Med Assoc 1962; 181: 17-24.
Health and Community Services Victoria. Protection and care. What is child abuse? Melbourne: Health and Community Services, Victoria,1995.
Welbury RR and Murphy JM. The dental practitioner’s role in protecting children from abuse 3. Reporting and subsequent management of abuse. Br Dent J 1998;184: 115-119.
World Health Organization. Prevention of child abuse and neglect: making the links bet- ween human rights and public health.Geneva: 2001 ;World Health Organization
Jirapramukpitak T, Prince M and Harpham T. The experience of abuse and mental health in the young Thai population. A preliminary survey Soc Psychiatr Epidermiol 2005; 40: 955-963.
Youssef R M, Attia M S and Kamel M I. Children experiencing violence: parental use of corporal punishment. Child Abuse Negl 1998; 22: 959-973.
Madu SN. The prevalence of child abuse among university students. Southern African Journal of Child and Adolescent Mental Health 2002; 14:123-127.
Oloko S B A, Ogbauagu S and Kisseka M. Situation analysis of children in especially difficult circumstances. Lagos (UNICEF) 1992.
Olley BO. Social and health behaviours in youth of the streets of Ibadan, Nigeria. Child Abuse Negl 2006; 30: 271-282
Sopher IM. The dentist and the battered child syndrome. Dent Clin North Am 1977; 21: 113- 122.
Becker DB, Needleman HL and Kolechuck M.Child abuse and dentistry. Orofacial trauma and recognition by dentists. J Am Dent Assoc 1978; 97:24-28
Needleman HL. Orofacial trauma in child abuse. Types, prevalence, managements and the dental profession’s involvement. Pediatr Dent 1986; 8:71-79.
Da Fonseca MA, Feigal RJ and Ten Bensel RW. Dental aspects of 1, 248 cases of child maltreatment on file at a major county hospital. Pediatr Dent 1992; 14: 152-157.
Jessee S A. Physical manifestations of child abuse to head , face and mouth: a hospital survey. J Dent Child 1995; 62: 245-249.
Ramos –Gomez F, Rothman D and Blain S. Knowledge and attitudes among California dental care providers regarding abuse and neglect. J Am Dent Assoc1998; 129: 340-348
Cairns AM, Mok JYQ and Welbury RR. Injuries to the face, mouth, and neck in physi- cally abused children in a community setting. Int J Paediatr Dent 2005; 15: 310-318.
John V, Messer L B, Arora R, Fung S, Hatzis E, Nguyen T, San A and Thomas K. Child abuse and dentistry: A study of knowledge and attitudes among dentists in Victoria, Australia.
Aust Dent J 1999; 44: 259-267.
World Corporal Punishment Research. Laws, rules and procedural details for administration of corporal punishment, eyewitness accounts, also legal judgments and commentaries.www. corpun.com/rules.htm
Eagly AH. Sex differences in social behaviour. A social role interpretation. Hillsdale, NJ: Erlbaum 1987.( www.ancpr.org/mothers-and-fathers-gender.html)
Blain SM, Winegarden T, Barber T K and Sognnaes R. Child abuse and neglect. II. 57th General Session of IADR , New Orleans,USA, March29- April 1 1979. Abstr 1105.
Mazakaris L . Dental aspects of child abuse. A New Zealand perspective (www. nzda.org. nz/Dental-Aspects –of-Child-Abuse).
Lough P. Mandated reporting of child abuse: Answers for dentists. J Calif Dent Ass 2004; 32: 307-312.
Ebigbo P O. Street children: The core of child abuse and neglect in Nigeria. Children, Youth and Environments; 13: Spring 2003
Kirschner R H and Stein R J. The mistaken diagnosis of child abuse. Am J Dis Child 1985; 139:873-875.
Malecz R E. Child abuse, its relationship to paedodontics: A survey. J Dent Child 1979; 46: 193-194.
Wilson –Oyelaran EB. The ecological model and study of child abuse in Nigeria. Child Abuse Negl 1989: 378-387.
Ogundele BO and Ojo RA. Selected sociodemographic factors as correlates of child abuse and neglect among parents in Ibadan, Oyo State. Ethno-Med 2007; 2: 147-151
Ammerman R T and Patz R J. Determinants of child –abuse potential: Contribution of parent and child factors. J Clin Child Psychol 1996; 25: 300-307.
Tsang A and Sweet D. Detecting child abuse and neglect- Are dentists doing enough? J Can Dent Assoc 1999; 65: 387-391
Hebert C P. Family violence and family physicians. Can Fam Physician 1991; 37: 385-390.