Abstract

Background and Aims: Child maltreatment is a major global public health concern. Non-accidental visceral injury (NAVI) is a type of injury that is deliberately inflicted on the human body, resulting in injury to internal organs, which is considered child abuse. This study aimed to identify the prevalence of NAVI and determine the characteristics of non-accidental injuries among children in Saudi Arabia (SA). Methods: A cross-sectional study was conducted based on the National Family Safety Registry (NFSR), which consists of 62 child-protection centres among health sector in SA. A total of 30 children with NAVIs were registered in the NFSR from April 2017 to March 2022. Results: The children mean age was 6.5±4.7 years.There was a sharp increase in NAVI cases over the five-year period, particularly after 2020, from two cases per year in 2017 to nine cases in 2021. NAVI predominantly affected children aged 5-10 years (40.1%). Lung injury was the most common form of NAVI, accounting for 23.3% of the cases. As a consequence of NAVI, 2 of the victims has died and 7 of them had deteriorated health status. Conclusions: NAVI in children in SA is a significant problem. This study provides important information on the socio-demographic characteristics and injury patterns of children with NAVI. This information can help develop prevention and intervention strategies to reduce the incidence of NAVI among children in SA.

Keywords: Child maltreatment · Non-accidental-visceral injuries · National Family Safety Registry · physical abuse · violence

References

  1. 1.Violence prevention [Internet], Violence Prevention. 2024. Available from: https://www.cdc.gov/violenceprevention
  2. 2.World Health Organization: Violence against children. (2022). Accessed: May 21, 2023: https://www.who.int/news-room/- fact-sheets/detafl/violenceagainstchildren
  3. 3.Sebastien, Orellana., Richard, A., I., Beth­ lehem., Ivan, L., Simpson-Kent., Anne-Laura, van, Harmelen., Petra, E., Vertes., Edward, T., Bullmore. Childhood maltreatment influences adult brain struc­ ture through its effects on immune, metabol­ ic and psychosocial factors. medRxiv, (2023). doi: 10.1101/2023.06.15.23291420 doi:10.1101/2023.06.15.23291420
  4. 4.John, A.M., Gall., John, A.M., Gall. Phys­ ical Child Abuse. (2020). doi: 10.1007/978-3-030-29462-5.5 doi:10.1007/978-3-030-29462-5.5
  5. 5.Sarah, Aldharman., Wed, S, Alotaibi., Asma, Alqahtani., Hassan, Saleheen., Maha, Almuneef. Determining the Prevalence of Child Maltreatment Among Young Adults in Saudi Arabia Using ISPCAN Child Abuse Screening Tool. Cureus, (2023). doi: 10.7759/cureus.38531 doi:10.7759/cureus.38531
  6. 6.Abdominal Trauma. (2023). doi: 10.5772/intechopen. 109615 doi:10.5772/intechopen
  7. 7.Barbara, L., Knox., Suzanne, R, Starling., Kenneth, W., Feldman., Nancy, D., Kellogg., Lori, D., Frasier., Suzanna, L., Tiapula. Child Torture as a Form of Child Abuse. Journal of Child & Adolescent Trauma, Characteristics and Outcomes of Non-accidental Visceral Injuries Among Children: Five Years’ Experience of National Data in Saudi Arabia Majmaah Journal of Health Sciences , Volume 12 Issue 4 October 2024, Rabi Al-Awwal 1446 (2014). doi: 10.1007/S40653-016-0108-X doi:10.1007/S40653-016-0108-X
  8. 8.Austin AE, Lesak AM, Shanahan ME: Risk and protective factors for child mal­ treatment: A review. Curr Epidemiol Rep. 2020, 7:334-42. 10.1007/s40471-020-00252-3 doi:10.1007/s40471-020-00252-3
  9. 9.Piteau SJ, Ward MG, Barrowman NJ, Plint AC: Clinical and radiographic charac­ teristics associated with abusive and nonabusive head trauma: a systematic review. Pedi­ atrics. 2012, 130:315-23. 10.1542/- peds.2011-1545 doi:10.1542/-
  10. 10.Benan, Shu. Update on Non-accidental Trauma. (2022). doi: 10.1007/978-981-19-4963-0_14 doi:10.1007/978-981-19-4963-0_14
  11. 11.Muhammad, Romail, Manan., Sara, Rahman., Leah, Komer., Hamna, Manan., Saadia, Iftikhar. A Multispecialty Approach to the Identification and Diagnosis of Non­ accidental Trauma in Children. Cureus, (2022). doi: 10.7759/cureus.27276 doi:10.7759/cureus.27276
  12. 12.Al Eissa M, Almuneef M: Child abuse and neglect in Saudi Arabia: journey of rec­ ognition to implementation of national pre­ vention strategies. Child Abuse Negl. 2010, 34:28-33.10.1016/j.chiabu.2009.08.011 doi:10.1016/j.chiabu.2009.08.011
  13. 13.Ute, Ziegenhain., Anne, Katrin, Kunster., Tanja, Besier. Violence against children. Bundesgesundheitsblatt-gesundheitsforschung-gesundheitsschutz, (2016). doi: 10.1007/S00103-015-2271-X doi:10.1007/S00103-015-2271-X
  14. 14.The National Family Safety Program: Hospital Based Child Maltreatment Regis­ try Annual Report. (2016). Accessed: No­ ve mber 18,2021. http s ://nfsp. org. sa/ar/proj - ects/NationalRecord/Documents/NFS- R%202016_Ar_En.pdf
  15. 15.Almuneef MA, Philip W, Almuntaser M: Characteristics of nonaccidental frac­ tures in abused children in Riyadh, Saudi Arabia. Saudi J Med Med Sci. 2019, 7:9-15. 10.4103/sjmms.sjmms_12_18 doi:10.4103/sjmms.sjmms_12_18
  16. 16.Simon, Kennedy., Susan, Bewley., Jane, Chevous., Concetta, Perot., Marcella, Characteristics and Outcomes of Non-accidental Visceral Injuries Among Children: Five Years’ Experience of National Data in Saudi Arabia Majmaah Journal of Health Sciences , Volume 12 Issue 4 October 2024, Rabi Al-Awwal 1446 Vigneri., Loraine, J., Bacchus. A systematic review that evaluates the extent and quality of involving childhood abuse survivors in shaping, conducting and disseminating re­ search in the UK. Research for all, (2022). doi: 10.14324/rfa.06.1.03 doi:10.14324/rfa.06.1.03
  17. 17.Sedlak A,Mettenburg J, Basena M, Petta I, McPherson K, Greene A, Li S: Fourth National Incidence Study of Child Abuse and Neglect (NIS-4): Report to Congress. (2010). Washington, DC: U.S. Department Of Health And Human Services, Adminis­ tration for Children and Families. http://www.acf.hhs.gov/programs/opre/abuse_neglect/ natl_incid/index.html
  18. 18.Masako, Tanaka., Katholiki, Georgiades., Michael, H., Boyle., Harriet, L., Mac­ Millan. Child Maltreatment and Education­ al Attainment in Young Adulthood Results From the Ontario Child Health Study. Jour­ nal of Interpersonal Violence, (2015). doi: 10.1177/0886260514533153 (education level) doi:10.1177/0886260514533153
  19. 19.Malik F: Determinants of child abuse in Pakistani families: parental acceptance-re­ jection and demographic variables. Int J Bus SocSci. 2010,1:67-80
  20. 20.Almuneef MA, Alghamdi LA, Saleheen HN: Family profile of victims of child abuse and neglect in the Kingdom of Saudi Arabia. Saudi Med J. 2016, 37:882-8. 10.15537/smj.2016.8.14654 doi:10.15537/smj.2016.8.14654
  21. 21.Alokan FB, Kemi B: The correlation be­ tween parents’ educational status and child abuse. Hum Soc Sci J. 2010,5:73-9
  22. 22.Andrea, J., Darling., Simon, Hackett., Kimberly, Jamie. Female sex offenders who abuse children whilst working in organisational contexts: offending, convic­ tion and sentencing. Journal of Sexual Ag­ gression, (2018). doi: 10.1080/13552600.2018.1476601 doi:10.1080/13552600.2018.1476601
  23. 23.Quiroz HJ, Parreco J, Easwaran L, et al.: Identifying populations at risk for child abuse: a nationwide analysis. J Pediatr Surg. 2020, 55:135-9. 10.1016/j.jpedsurg.2019.09.069 doi:10.1016/j.jpedsurg.2019.09.069
  24. 24.AlMadani O, Bamousa M, Alsaif D, Kharoshah MAA, Alsowayigh K: Child physical and sexual abuse in Dammam, Saudi Arabia: A descriptive case-series anal­ ysis study. Egypt J Forensic Sci. 2012, 2:33-7.10.1016/j.ejfs.2012.01.001 doi:10.1016/j.ejfs.2012.01.001
  25. 25.Lane WG, Dubowitz H, Langenberg P, Dischinger P: Epidemiology of abusive ab­ dominal trauma hospitalizations in United States children. Child Abuse Negl. 2012, 36:142-8.10.1016/j.chiabu.2011.09.010 doi:10.1016/j.chiabu.2011.09.010
  26. 26.Sheybani EF, Gonzalez-Araiza G, Kousari YM, Hulett RL, Menias CO: Pediatric nonaccidental abdominal trauma: what the radiologist should know. RadioGraphics. 2014,34:139-53.10.1148/rg.341135013 doi:10.1148/rg.341135013
  27. 27.Narendra, Kumar., Anita, Singh., Yadvendra, Dheer., Sandeep, Tiwari., Samir, Misra., Harshit, Agarwal. Pancreatic Inju­ ry—a Case Series Analysis from a Level I Trauma Center. Indian Journal of Surgery, (2021). doi: 10.1007/S12262-020-02664-3 doi:10.1007/S12262-020-02664-3
  28. 28.Nasser, A, N, Alzerwi. Traumatic injuries to the renal blood vessels and in-hospital renal complications in patients with pene­ trating or blunt trauma. Frontiers in Surgery, (2023). doi: 10.3389/fsurg.2023.1134945. Characteristics and Outcomes of Non-accidental Visceral Injuries Among Children: Five Years’ Experience of National Data in Saudi Arabia doi:10.3389/fsurg.2023.1134945

Peer review

Peer reviewed by 2 reviewers, who chose to remain anonymous.

Majmaah Journal of Health Sciences · eISSN 1658-8223 · Majmaah University · open access