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Epidemiology of sexually transmitted infections in suspected child victims of sexual assault.
Pediatrics 2009; 124(1):79-86Ped

Abstract

OBJECTIVE

The objective of this study was to describe the epidemiology of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Treponema pallidum, HIV, and herpes simplex virus type 2 (HSV-2) infection diagnosed by culture or by serologic or microscopic tests and by nucleic acid amplification tests in children who are evaluated for sexual victimization.

METHODS

Children aged 0 to 13 years, evaluated for sexual victimization, who required sexually transmissible infection (STI) testing were enrolled at 4 US tertiary referral centers. Specimens for N gonorrhoeae and C trachomatis cultures, wet mounts for detection of T vaginalis, and serologic tests for syphilis and HIV were collected and processed according to study sites' protocols. Nucleic acid amplification tests for C trachomatis and N gonorrhoeae and serologic tests for HSV-2 were performed blinded to other data.

RESULTS

Of 536 children enrolled, 485 were female. C trachomatis was detected in 15 (3.1%) and N gonorrhoeae in 16 (3.3%) girls. T vaginalis was identified in 5 (5.9%) of 85 girls by wet mount, 1 (0.3%) of 384 children had a positive serologic screen for syphilis, and 0 of 384 had serologic evidence of HIV infection. Of 12 girls who had a specimen for HSV-2 culture, 5 (41.7%) had a positive result; 7 (2.5%) of 283 had antibody evidence of HSV-2 infection. Overall, 40 (8.2%) of 485 girls and 0 of 51 boys (P = .02) had >or=1 STI. Girls with vaginal discharge were more likely to test positive for an STI (13 [24.5%] of 53) than other girls (27 [6.3%] of 432; prevalence ratio = 3.9; P < .001), although 10 girls with STIs had normal physical examinations. Most girls (27 [67.5%]) with a confirmed STI had normal or nonspecific findings on anogenital examination.

CONCLUSIONS

The prevalence of each STI among sexually victimized children is <10%, even when highly sensitive detection methods are used. Most children with STIs have normal or nonspecific findings on physical examination.

Authors+Show Affiliations

Department of Pediatrics, University of Texas-Houston Medical School, Houston, Texas 77030, USA. rebecca.g.girardet@uth.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

19564286

Citation

Girardet, Rebecca G., et al. "Epidemiology of Sexually Transmitted Infections in Suspected Child Victims of Sexual Assault." Pediatrics, vol. 124, no. 1, 2009, pp. 79-86.
Girardet RG, Lahoti S, Howard LA, et al. Epidemiology of sexually transmitted infections in suspected child victims of sexual assault. Pediatrics. 2009;124(1):79-86.
Girardet, R. G., Lahoti, S., Howard, L. A., Fajman, N. N., Sawyer, M. K., Driebe, E. M., ... Black, C. M. (2009). Epidemiology of sexually transmitted infections in suspected child victims of sexual assault. Pediatrics, 124(1), pp. 79-86. doi:10.1542/peds.2008-2947.
Girardet RG, et al. Epidemiology of Sexually Transmitted Infections in Suspected Child Victims of Sexual Assault. Pediatrics. 2009;124(1):79-86. PubMed PMID: 19564286.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of sexually transmitted infections in suspected child victims of sexual assault. AU - Girardet,Rebecca G, AU - Lahoti,Sheela, AU - Howard,Laurie A, AU - Fajman,Nancy N, AU - Sawyer,Mary K, AU - Driebe,Elizabeth M, AU - Lee,Francis, AU - Sautter,Robert L, AU - Greenwald,Earl, AU - Beck-Sagué,Consuelo M, AU - Hammerschlag,Margaret R, AU - Black,Carolyn M, PY - 2009/7/1/entrez PY - 2009/7/1/pubmed PY - 2009/9/23/medline SP - 79 EP - 86 JF - Pediatrics JO - Pediatrics VL - 124 IS - 1 N2 - OBJECTIVE: The objective of this study was to describe the epidemiology of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Treponema pallidum, HIV, and herpes simplex virus type 2 (HSV-2) infection diagnosed by culture or by serologic or microscopic tests and by nucleic acid amplification tests in children who are evaluated for sexual victimization. METHODS: Children aged 0 to 13 years, evaluated for sexual victimization, who required sexually transmissible infection (STI) testing were enrolled at 4 US tertiary referral centers. Specimens for N gonorrhoeae and C trachomatis cultures, wet mounts for detection of T vaginalis, and serologic tests for syphilis and HIV were collected and processed according to study sites' protocols. Nucleic acid amplification tests for C trachomatis and N gonorrhoeae and serologic tests for HSV-2 were performed blinded to other data. RESULTS: Of 536 children enrolled, 485 were female. C trachomatis was detected in 15 (3.1%) and N gonorrhoeae in 16 (3.3%) girls. T vaginalis was identified in 5 (5.9%) of 85 girls by wet mount, 1 (0.3%) of 384 children had a positive serologic screen for syphilis, and 0 of 384 had serologic evidence of HIV infection. Of 12 girls who had a specimen for HSV-2 culture, 5 (41.7%) had a positive result; 7 (2.5%) of 283 had antibody evidence of HSV-2 infection. Overall, 40 (8.2%) of 485 girls and 0 of 51 boys (P = .02) had >or=1 STI. Girls with vaginal discharge were more likely to test positive for an STI (13 [24.5%] of 53) than other girls (27 [6.3%] of 432; prevalence ratio = 3.9; P < .001), although 10 girls with STIs had normal physical examinations. Most girls (27 [67.5%]) with a confirmed STI had normal or nonspecific findings on anogenital examination. CONCLUSIONS: The prevalence of each STI among sexually victimized children is <10%, even when highly sensitive detection methods are used. Most children with STIs have normal or nonspecific findings on physical examination. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/19564286/Epidemiology_of_sexually_transmitted_infections_in_suspected_child_victims_of_sexual_assault_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=19564286 DB - PRIME DP - Unbound Medicine ER -