Sexually transmitted diseases in young children in Lome (Togo). Place of sexual abuse.

Objective. - The purpose of this study was to determine the importance of s exual abuse in young children with sexually transmitted diseases (STD) in L ome (Togo). Methods. - This transversal study consisted of documenting all cases of STD in young children (up to II years of age) diagnosed during 20 months (May 1997 to December 1998) in the dermato-venereology unit of the Lome teaching hospital. Syphilitic (TPHA-VDRL) and HIV serologies were carried out in al l children. These serologies were repeated two weeks and three months later in sexually abused children. Results. - During this period, 33 cases of STD were diagnosed. There were 1 6 cases of anogenital warts (13 females, three males; mean age: 5.6 +/- 2.4 years); 13 cases of gonorrhoea tall were females; mean age: 7.2 +/- 1.8 ye ars); and four cases of genital trichomoniasis (four females; mean age: 6.2 years). In 12 of 13 cases of gonorrhoea, sexual abuse was noted with ident ification of the alleged contaminators in ten cases. In eight of 16 cases o f anogenital warts tall observed in females; mean age: 6.1 +/- 1.9 years), and two Of four cases of genital trichomoniasis (mean age: six years) sexua l abuse was observed. Syphilitic serology was negative in all children, but one ten-year-old girl had HIV infection with identification of the alleged contaminator. Conclusion. - The results of this study confirm that sexual abuse in childr en is not uncommon in black Africa and that the STD, like condylomata acumi nata and gonorrhoea, are good indicators of this phenomenon. The classical consequences of such sexual abuses are aggravated in Africa by the high pre valence of HIV infection observed in the majority of countries, mainly in u rban areas. (C) 2001 Editions scientifiques et medicales Elsevier SAS.