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A novel ED-based sexual assault centre in western Kenya: description of patients and analysis of treatment patterns
  1. Megan L Ranney1,
  2. Elissa Rennert-May2,
  3. Rachel Spitzer2,
  4. Mary Anyona Chitai3,
  5. Sarah Ellen Mamlin3,4,
  6. Hillary Mabeya5
  1. 1Injury Prevention Center, Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
  2. 2Department of Obstetrics & Gynecology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3Center for Assault Recovery-Eldoret, Accident & Emergency, Department of Surgery, Moi Teaching & Referral Hospital, Eldoret, Kenya
  4. 4Department of Medicine, Indiana University, Indianapolis, Indiana, USA
  5. 5Department of Obstetrics & Gynecology, Moi University, Eldoret, Kenya
  1. Correspondence to Megan L Ranney, Assistant Professor, Injury Prevention Center, Dept of Emergency Medicine, Alpert School of Medicine, Brown University, 55 Claverick St, 2nd Flr, Providence, RI 02903, USA; mranney{at}lifespan.org

Abstract

Background The aim of this study was to establish the feasibility of a Kenyan emergency department (ED)-based sexual assault centre; and to improve knowledge of the characteristics of sexual assault in the region.

Methods The Center for Assault Recovery-Eldoret (CAR-E) was established to provide timely, culturally sensitive treatment of Kenyan sexual assault survivors using a standardised evaluation/treatment protocol. A retrospective review of charts of all sexual assault survivors attending CAR-E from May 2007–May 2008 was performed. Simple descriptive statistics, t tests, and OR were calculated.

Results CAR-E treated 321 survivors over 13 months. Patients' mean age was 15.9 years; 50% were younger than 14 years old. Survivors were predominately female and single. Most knew their assailant. Younger age was associated with increased likelihood of genital trauma. Only 43% of assaults were reported to the police. Sexually transmitted infection prophylaxis was given per protocol to 84% eligible; emergency contraception to 64%; and HIV prophylaxis to 63%. Only 44% received counselling. Survivors were more likely to get sexually transmitted infection and HIV prophylaxis, and emergency contraception if they had genital injury.

Conclusions Development of an ED-based sexual assault centre at a referral hospital in Kenya using a standardised history, physical, and treatment protocol was feasible, and high rates of prophylaxis were provided. Based on characteristics of people who have been assaulted, community prevention efforts should concentrate on decreasing the societal acceptability of rape. In conjunction with improvement of protocols at the centre under consideration, development of similar centres in sub-Saharan African ED should be encouraged.

  • Emergency service
  • hospital/standards
  • Kenya
  • rape
  • sexually transmitted diseases/prevention & control
  • violence
  • accident prevention
  • paediatrics
  • non-accidental injury
  • violence
  • wounds
  • treatment
  • wounds
  • research

Statistics from Altmetric.com

Footnotes

  • Poster presentation #316 at SAEM Annual Meeting, New Orleans, LA, May 2009.

  • Funding At the time of the study, CAR-E received funding only from MTRH.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Lifespan/Brown University; University of Toronto; Moi University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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