CORTISOL AND C-REACTIVE PROTEIN (CRP) LEVELS IN CHILDREN EXPOSED TO PHYSICAL AND SEXUAL VIOLENCE ATTENDING MENOUFIA UNIVERSITY HOSPITALS.

Abstract

BACKGROUND: Children maltreatment is a common problem worldwide which needs proper evaluation for better management and prevention. OBJECTIVES: This study aimed to investigate whether violence (physical and sexual) in children is associated with changes in cortisol hormone and C-reactive protein (CRP) levels and their potential role in evaluating type, frequency, severity, and outcome of such violence. METHODOLOGY: This study included all children presented to Menoufia university hospital suffering from physical or sexual violence during the period of study, from the 1 st of December 2016 to the 30 th of November 2018. A clinical sheet was predesigned and fulfilled for the cases. Injured Patients were classified according to injury severity score (ISS). Blood samples were taken from case and controls groups for estimation of Cortisol and CRP levels. RESULTS: The study included 75 children who were victims of violence (physical or sexual) with girls’ predominance mostly from rural areas. Physical violence outnumbered sexual violence and violence was predominantly repeated. Contusions were the most presented external injuries while fractures were the commonest in internal injuries. According to ISS more than half of victims were of serious degree. The mortality rate was 8%. Violence against children was associated with changes in cortisol and CRP levels in comparison to controls. Cortisol levels changes were strongly connected to the type, frequency, and severity of violence, as well as the outcome of the cases, whereas changes in CRP levels were significantly related to the type and frequency of violence, and outcome of the cases. CONCLUSION: These markers could help physicians in early diagnosis and evaluation of children’s physical and sexual maltreatment as evidence of stress and inflammation especially in cases with vague history of abuse and vague physical signs that are not conclusive for assault.