Introduction

Child abuse is a social problem with far-reaching consequences. Serious underreporting of cases occurs, and no studies could be found which investigates the South African context of the problem. In this study we aimed to determine the profile of victims of fatal child abuse in the Southern Free State.

Methods

All child deaths of children 10 years and younger in the period 1 January 1995 to 31 December 2003 were identified in the register of deaths at the SA Police Mortuary, Bloemfontein. The reports of these deaths were evaluated to identify possible cases of fatal child abuse. Irrelevant reports were eliminated until a group of possible cases of fatal child abuse were identified. In cases where there was uncertainty about the cause of death, a registrar in Forensic Medicine was consulted. In some cases she advised that a history be obtained from police reports. Cases which could not be confirmed in this way were included in a so-called grey area. Nineteen cases were identified, and a further 4 placed in the grey area.

Results

Of the 19 cases, the majority were female (14). The median age of cases was 2 years. Cases showed an even distribution regarding race. No patterns regarding annual or monthly distribution were found. Most victims, 73.7% (14 of 19 cases), were of normal weight and no victims suffered from malnutrition. Head injuries were the most common cause of death (63.2%) followed by multiple injuries (21.2%).

Conclusion

If doctors are aware of the signs of child abuse cases can be identified early. In this way a significant decrease in mortality and morbidity can occur.