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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2012.213asm-2-213aCommentsRE: Reported child sexual abuse in Bahrain: 2000–2009 Al-Mendalawi Mahmood D. Department of Pediatrics and Child Health, Al Kindy College of Medicine, Baghdad University, Baghdad, Iraq, mdalmendalawi@yahoo.comMar-Apr 2012 32 2 213 213 Copyright © 2012, Annals of Saudi Medicine2012This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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To the Editor: I totally agree with Al-Mahroos and Al-Amer1 in their claim that it was not clear if the rise in the number of child sexual abuse (CSA) cases reported in Bahrain was due to a genuine increase in the incidence of CSA cases or due to increased public and professional awareness and improved recognition and referral. However, it should be noted that various factors might contribute to the inaccurate reporting of CSA. They include the following: age of the abused child at the time of the event, the relationship between the perpetrator and the abused child, the gender of the abused child, the severity of the abuse, the developmental and cognitive status of the abused child, and the likely consequence of disclosure.2 Nevertheless, the 2.5% increase in reported cases of CSA in Bahrain in 10 years (2000–2009)1 is alarming. It really contradicts an older report that demonstrated that CSA cases in developing countries like the United States have declined approximately 39% from 1992 to 1999, according to estimates from the National Child Abuse and Neglect Data System (NCANDS). A diverse array of possible causes for that decline was postulated including: increased evidentiary requirements to substantiate cases, increased caseworker caution due to new legal rights for caregivers, and increasing limitations on the types of cases that agencies accept for investigation.3 Reinforcing the need for governments to take a systems approach to child protection, including policy/legislation, information-based programs and social services, as well as professional training and public awareness raising represent top-ranked priorities to contain the issue of CSA.4
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REFERENCES
1 Al-Mahroos F  Al-Amer E   Reported child sexual abuse in Bahrain: 2000–2009 Ann Saudi Med 2011 31 376 82 21808114 
2 Violence against women: A priority health issue Geneva World Health Organization 1997 1 12 
3 Jones LM  Finkelhor D  Kopiec K   Why is sexual abuse declining? A survey of state child protection administrators Child Abuse Negl 2001 25 1139 58 11700689 
4 Svevo-Cianci KA  Hart SN  Rubinson C   Protecting children from violence and maltreatment: a qualitative comparative analysis assessing the implementation of U.N. CRC Article 19 Child Abuse Negl 2010 34 45 56 20060588