Lien entre l’agression sexuelle durant l’enfance et le développement de maladies infectieuses non transmises sexuellement
Child sexual abuse is a prevalent worldwide problem and is associated with numerous psychological consequences, including anxiety, depression, post-traumatique stress disorder and suicide ideation both in childhood and adulthood. With respect to physical health, in adulthood, child sexual abuse is associated with increased gastrointestinal symptoms, gynecological symptoms, cardio-respiratory symptoms, pain and obesity. However, few studies have documented the specific repercussions of child sexual abuse on the physical health of children and adolescents. In youth, child maltreatment, which includes child sexual abuse, is associated to more asthma, migraines, somatic complaints and increased hospitalisations for various physical health problems. The association between childhood adversity and various chronic diseases is only partially explained by at-risk behaviors (eg., smoking and physical inactivity), and therefore, it has been postulated that childhood adversity can lead to a dysregulation of the immune and endocrine systems, which would then lead to chronic inflammation, and therefore, to physical health problems. The main objective of this doctoral essay was to determine if there is an association between child sexual abuse and the development of infectious diseases in children and adolescents, which could be an early clinical manifestation of the dysregulation of the immune and endocrine systems. Of the 955 eligible children and adolescents who had a substantiated report of sexual abuse between January 1st 2001 and Décember 31st 2010, medical data was retrieved for 882 individuals, who formed the sexually abused group. These 882 children and adolescents were matched to 882 participants on age, gender, and administrative healthcare region to form the general population group. This matched-cohort study compared the number of infectious disease diagnoses between the two groups between the date of the substantiated sexual abuse report and August 1st 2013. Results indicate that sexually abused participants had 1.27 times more (95% CI – 1.13 to 1.42; p < 0.001) infectious diseases diagnoses than those from the general population. They received 1.83 times more genitourinary infections diagnoses (95% CI – 1.43 to 2.33; p < 0.001), 1.31 times more diagnoses for other types of infections (95% CI – 1.11 to 1.55; p = 0.002) and 1.21 times more respiratory and ear infection diagnoses (95% CI – 1.05 to 1.40; p = 0.007). There was no statistically significant difference regarding skin infection diagnoses. These results indicate an association between CSA and more frequent diagnoses for all types of infections, genitourinary infections, respiratory and ear infections and other types of infections but not for skin infections. Preventative measures and interventions should be implemented for sexually abused youth who have infections.
Child sexual abuse Children Adolescent Physical health Infectious diseases Matched-cohort study