Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Knowledge and attitudes regarding child abuse and child rights among Sri Lankan school children(Sri Lanka Medical Association, 2012) Mettananda, S.; de Silva, D.G.H.; Perera, T.; Pathmeswaran, A.AIMS: To describe knowledge and attitudes regarding child abuse and child rights among school children in 3 districts in Sri Lanka. METHODS: A descriptive study was conducted in Anuradapura, Monaragala and Kandy districts in 2011. Five schools were randomly selected from each district. Three classes of grades 9-11 were randomly selected and all students in selected classes were recruited into the study after obtaining informed consent. A self-administered questionnaire given under examination conditions was used to gather data. The questionnaire contained questions to assess knowledge/attitudes regarding child abuse and rights. Subjects were assigned a mark (range 0-5) on their answers to questions in different aspects of child abuse and higher marks signify better knowledge. RESULTS: The study population comprised 1091 adolescents (Anuradapura-30%, Moneragala-35%, Kandy-34%). Mean age was 14.2 (SD±1.23) years and 48% were males. The majority of boys (85%) and girls (78%) were unaware of the child rights convention. A higher percentage of girls (10.1%) than boys (5.2%) answered the question on child rights satisfactorily [p=0.003]. Corporal punishment in schools was recommended by 38%, whereas 42% suggested positive disciplinary methods. On other's request, 29% boys and 6% girls would do life-endangering tasks. Marks for the question regarding ability to handle/avoid sexual abuse were- 0 in 7%, 1-3 in 51% and 4-5 in 42%. Girls scored significantly higher than boys [p<0.001]. CONCLUSIONS: Knowledge regarding child rights among Sri Lankan children was unsatisfactory. A high proportion acknowledged corporal punishment as a disciplinary method. Girls had a better knowledge regarding child rights and are better aware of how to handle situations of sexual abuse.Item Experience of abuse among Sri Lankan school children(Sri Lanka Medical Association, 2012) Mettananda, S.; de Silva, D.G.H.; Perera, T.; Pathmeswaran, A.AIMS: To describe the experiences of abuse and maltreatment among children and adolescents in 3 districts in Sri Lanka. METHODS: A descriptive study was conducted in Anuradapura, Monaragala and Kandy districts in January-March 2011. Five schools were randomly selected from each district. Two primary classes [grade 4-5 [children)] and 3 senior classes [grades 9-11 [adolescents]] were randomly selected and all students in selected classes were recruited into the study after obtaining informed consent from students and staff. A self administered questionnaire given under examination conditions was used to gather data. The questionnaire contained questions regarding experiences of physical, emotional and sexual abuse. Results: The study population comprised 739 children [Anuradapura-279, Moneragala-207, Kandy-253) and 1091 adolescents [Anuradapura-327, Moneragala-387, Kandy-377). Male; female ratio was 49:51. 75% children and 91% adolescents claimed that they are physically punished when they misbehave in school, whereas 79% and 97% respectively, agreed that they are shouted at. 28% adolescents [MaIe-49%, Female-10%) had performed life endangering tasks, and in 43% the caretaker/adult had requested it of them. Part-time child labour was reported by 2.7% children and 1.6% adolescents. 2.6% children [Male-3.6%, Female-1.7%) and 1.7% adolescents [Male-2%, Female-1.4%) had experienced incidents of sexual abuse. 14% children and 7% adolescents were staying alone at home whereas 37% children and 49% adolescents travelled alone. CONCLUSIONS: Corporal punishment, although banned, is still being widely used as a disciplinary method. About 2% of school children had experienced sexual abuse. Significant proportions of school children were either living alone or going out alone, and are therefore at risk of abuse.Item Child abuse and neglect; who gets abused and who abuses them?(Sri Lanka Medical Association, 2005) Fernando, A.D.; Karunasekera, K.A.W.; Fernando, L.; Samarasekera, A.OBJECTIVES: To study the socio-demographic characteristics of victims of child abuse and characteristics of the perpetrators. Study Design: A descriptive study. METHOD: A prospective study of 112 victims of child abuse presenting to the University Paediatric Unit, Ragama from January 2000 to August 2004. The study evaluated characteristics of victims and perpetrators. Ethical approval was obtained. Data Analysis: Epi info version 6. RESULTS: Mean age of the victims was 9.7 years. 79% were females. Ethnicity-91% Singhalese, 5%Muslims and 4%Tamils. 82% resided in Gampaha District. Education of father and mother respectively - 5% and 11%-not attended school, 32% and 34%-primary education, 52% and 50%-ordinary level and 11% and 9%-advanced level. Social class -46%-unskilled, 26%-poorly skilled, 18%-skilled and 10%-lesser professionals. Monthly income (Rs.) -6% <2000, 37% 2000-5000, 33% 5000-10,000 and 24% >10,000. Marital status- 64%-married, 27%-divorced, 6%-unmarried and living together, 3%-single. Amongst married parents, 20% of mothers and 6% of fathers were abroad. Caregiver to the victim- 47%-both parents, 15%-mother, 15%-father, 14%-relatives and 9%-others. Consumption of alcohol by father -59%. Characteristics of perpetrators- 98% were known to the victims and in 24% the perpetrator was the father. Number of perpetrator/s- 86%-one, 5%-two, 5%-three, 4%-more than 3. Perpetrator being drunk at the tine of abuse in 31%. Amongst sexually abused, 26% were acts of incest. Of those 70% by father. CONCLUSIONS: The most vulnerable victims of abuse are shown to be 10-year-old females. Majority came from low social and educational backgrounds, In <5Q%, both parents cared for the child. 98% of perpetrators were trusted persons and in nearly a quarter it was the father.Item A profile of child abuse and neglect in a tertiary care hospital(Sri Lanka Medical Association, 2005) Fernando, A.D.; Karunasekera, K.A.W.; Fernando, L.; Samarasekera, A.OBJECTIVES: To study the pattern of child abuse and neglect. To evaluate the management and the Outcome of such victims STUDY DESIGN: A descriptive study METHOD: The sample consists of 112 victims of child abuse referred to the University Paediatric Unit, Ragama Hospital, from January 2000 to August 2004. The study prospectively evaluated types of abuse, their characteristics, management of victims and outcome. Ethical approval was obtained. RESULTS: 24% had more than one type of abuse. Categories of abuse were: 70% -sexual, 33% -physical, 16% -neglect, 14% -emotional and 6% -child labour. Amongst sexually abused, 62% had penetrative sex, 8% became pregnant, 4% had sexually transmitted diseases, 5% had severe degree perineal/peri-anal tears, and 37% had psychological disturbances at the time of presentation. 39% came for follow up assessment after 6 months. Amongst them, 60% had psychological disturbances, amongst physically abused, 19% had fractures. Amongst all victims, the mean duration of hospital stay was 29 days. Management outcome: 46% sent back to parents, 11% to extended family member/s, 38% to Children's Homes and 5% to others. CONCLUSIONS: 24% had more than one type of abuse. The commonest type was sexual abuse. The majority of them had penetrative sex and 8% became pregnant. Psychological disturbances were found in the majority of victims of sexual abuse on follow up. 57% of victims were able to continue to live with their parents/extended family.