Children with sexually transmitted diseases need better care

3.00pm

An increasing number of Auckland children are suffering from the sexually transmitted disease gonorrhoea and the problem is being poorly handled, according to child abuse assessment unit Whakaruruhau.

In the latest issue of the New Zealand Medical Journal, report author Patrick Kelly said the Auckland-based centre had seen 14 cases of genital gonorrhoea in pre-pubertal children between 1991 and 2002, 12 of these cases since 1997. Three of the children also had chlamydia.

A further four cases of gonorrhoea were reported by private laboratories in 1996 and 1997.

All positive gonorrhoea results for children were considered to be as a result of sexual abuse and appropriate authorities notified, the report said.

It was "worrying" that in 13 of the 14 cases seen at Whakaruruhau, the children had not been taken to the doctor for suspected sexual abuse, Dr Kelly said. They were taken with genital symptoms and the diagnosis made unexpectedly.

The issue of genital gonorrhoea in children was complicated by persistent questions about the means of transmission, the report said.

There was some argument about whether all cases were the result of sexual abuse or whether the organism responsible for the disease could survive on towels or toilet seats, for example.

However, Dr Kelly said there was general consensus in Western literature that genital gonorrhoea in children (other than babies infected through the birth process), was a sexually transmitted disease.

He was critical of the management of these cases of sexual abuse.

Dr Kelly identified difficulty in getting rapid and effective inter-agency communication set up, delays in interviewing children and in providing therapy, the low rate of disclosure by children, difficulty in identifying the source of infection, and the scarcity of prosecution.

"The diagnosis of gonorrhoea in a child should be treated with the same urgency as the child who turns up at school with inflicted bruises, or the child who makes a clear disclosure of sexual abuse by a caregiver residing in the home," Dr Kelly said.

A case conference within 24 hours of the diagnosis being made would help to achieve a better outcome for these children.

A multi-disciplinary approach to the problem was vital, and the challenges of dealing with such cases "must be overcome to interrupt the cycle of abuse".

- NZPA

Herald feature:

Child Abuse

Herald special report (Nov 28, 2001):

Building Tomorrow

Building Tomorrow - paths to prevent child abuse