Violence against children: an analysis of mandatory reporting of violence, Brazil 2011

Rates, Susana Maria Moreira; Melo, Elza Machado de; Mascarenhas, Márcio Dênis Medeiros; Malta, Deborah Carvalho

doi:10.1590/1413-81232015203.15242014

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Article • Ciênc. saúde coletiva 20 (3) • Mar 2015 • https://doi.org/10.1590/1413-81232015203.15242014 copy

Violence against children: an analysis of mandatory reporting of violence, Brazil 2011

Authorship SCIMAGO INSTITUTIONS RANKINGS

This article aims to describe and analyze reporting of violence against children from 0 to 9 years of age, issued by the public health services, in Brazil. Data from the Violence and Accident Surveillance System (Viva-SINAN) were used. The frequency of selected variables was calculated by age group (0-1; 2-5 and 6-9 years of age) as well as their Prevalence Ratios (PR). 17.900 cases were reported: 33% in the 0-1 year group; 35,8% in the 2-5 year group; and 31,2% in the 6-9 year group. Physical violence predominated among boys (PR: 1.22; CI 95%: 1,16-1,28 ); 6-9 years old (PR: 1,19; CI 95%: 1,12-1.27 ). Sexual violence predominated among girls, mulatto/afro-descendant (PR: 1.12; CI 95 %: 1.06 to 1.19 ); 6-9 years (PR: 4.63; CI 95%: 4.22- 5.08) with more chances of occurring at home (PR: 1.38 , CI: 95%: 1.29-1.48); psychological violence prevailed among girls, mulatto/afro-descendant (PR: 1.10; CI 95 %: 1.03-1.18 ), 6-9 years old (PR: 2.95; CI 95%: 2.69- 3.23), at home (PR: 1.40; CI 95%: 1.29-1.53); negligence predominated among boys (PR: 1.33 ; 95% CI: 1.27-1.39); 0-1 years and their parents were the most prevalent perpetrators.The results indicate the need to strengthen intersectoral actions aiming at extending the social protection and care network.

Domestic violence; Child abuse; Epidemiology; Reporting of violence

		Age bracket (years)
										Total
	0 to 1			2 to 5			6 to 9			Total
Characteristics	(N = 5,909;			(N = 6,401;			(N = 5,590;			(N = 17,900;		p-value
Characteristics	33.0%)		35.8%)			31.2%)			100.0%)			p-value
	33.0%)		35.8%)			31.2%)			100.0%)
	N	%		N	%		N	%		N	%

Sex [n = 17,900]												0.000
Female	3,066	51.9	3,564		55.7	3,093		55.3	9,723		54.3
Male	2,843	48.1	2,837		44.3	2,497		44.7	8,177		45.7
Race/skin color [n = 13,873]												0.000
White	2,235	51.8	2,551		50.4	2,049		45.6	6,835		49.3
Afro-descendant/mulatto	2,019	46.8	2,439		48.2	2,361		52.6	6,819		49.2
Indigenous	65	1.7	71		1.4	83		1.9	219		1.6
Deficiency [n = 12,972]												0.000
Yes	151	4.1	190		3.9	319		7.2	660		5.1
No	3,519	95.9	4,690		96.1	4,103		92.8	12,312		94.9
Region [17,900]												0.000
North	282	4.8	526		8.2	654		11.7	1,462		8.2
Northeast	958	16.2	960		15.0	911		16.3	2,829		15.8
Southeast	2,546	43.1	2,912		45.5	2,213		39.6	7,671		42.9
South	1,338	22.6	1,313		20.5	1,248		22.3	3,899		21.8
Mid-West	785	13.3	690		10.8	564		10.1	2,039		11.4

		Age bracket (years)
									Total
	0 to 1			2 to 5		6 to 9			Total
Characteristics	(N = 5,909;			(N = 6,401;		(N = 5,590;			(N = 17,900;		p-
Characteristics	33.0%)		35.8%)			31.2%)		100.0%)			p-
	33.0%)		35.8%)			31.2%)		100.0%)			value
	N	%		N	%	N	%		N	%	value
	N	%		N	%	N	%		N	%

Occurrence in the home [n = 15,655]											0.000
Yes	3,536	69.8	4,322		77.5	3,661	73.0	11,519		73.6
No	1,527	30.2	1,252		22.5	1,357	27.0	4,136		26.4
Repeated violence [n = 10,568]											0.000
Yes	1,083	35.4	1,463		39.7	2,057	53.8	4,603		43.6
No	1,980	64,6	2,219		60,3	1,766	46,2	5,965		56,4
Nature of injury [n = 13,634]											0.000
Bruise/sprain/wrench	570	11.9	577		12.1	624	15.3	1,771		13.0
Cut/amputation	461	9.6	542		11.4	543	13.3	1,546		11.3
Fracture/traumas	612	12.8	401		8.4	269	6.6	1,282		9.4
Others	1,246	26.0	1,464		30.7	920	22.6	3,630		26.6
No injury	1,906	39.8	1,781		37.4	1,718	42.2	5,405		39.6
Body segment affected [n = 8,362]											0.000
Head/neck	1,278	48.2	919		29.9	760	28.8	2,957		35.4
Thorax/abdomen/pelvis	465	17.5	1,208		39.3	1,086	41.2	2,759		33.0
Upper members	320	12.1	296		9.6	279	10.6	895		10.7
Lower members	185	7.0	236		7.7	233	8.8	654		7.8
Multiple organs/regions	404	15.2	412		13.4	281	10.7	1,097		13.1
Evolution [n = 13,191]											0.000
High	3,675	83.7	4,322		91.5	3,827	93.9	11,824		89.6
Evasion/flight	593	13.5	359		7.6	217	5.3	1,169		8.9
Death by violence	75	1.7	29		0.6	25	0.6	129		1.0
Death from other causes	48	1.1	12		0.3	9	0.2	69		0.5
Place sent in health sector [n = 13,763]											0.000
Outpatient	2,163	49.2	3,222		64.7	3,098	70.7	8,483		61.6
Inpatient	1,430	32.5	1,034		20.8	593	13.5	3,057		22.2
No	808	18.4	722		14.5	693	15.8	2,223		16.2

		Age bracket (years)
										Total
	0 to 1			2 to 5			6 to 9			Total
Characteristics	(N = 5,909;			(N = 6,401;			(N = 5,590;			(N = 17,900;		p-value
Characteristics	33.0%)		35.8%)			31.2%)			100.0%)			p-value
	33.0%)		35.8%)			31.2%)			100.0%)
	N	%		N	%		N	%		N	%

Type of violence												0.000
Physical	1,863	37.6	1,863		33.5	2,243		44.9	5,969		38.5	0.000
Psychological/moral	608	12.9	1,311		24.3	1,853		38.2	3,772		25.2	0.000
Torture	90	2.0	79		1.5	168		3.6	337		2.3	0.000
Sexual	534	11.3	2,521		44.9	2,620		52.3	5,675		37.0	0.206
Financial/economic	44	0.9	34		0.6	41		0.9	119		0.8	0.000
Negligence	3,729	67.8	2,575		44.6	1,412		28.4	7,716		47.5	0.000
Clild labor	6	0.1	17		0.3	38		0.8	61		0.4	0.504
Legal Intervention	22	0.5	18		0.3	22		0.5	62		0.4	0.000
Others	285	6.2	179		3.5	112		2.5	576		4.0	0.000
Parents^a as perpetrators [17,900]
Yes	3,686	62.4	3,138		49.0	2,402		43.0	9,226		51.5
No	2,223	37.6	3,263		51.0	3,188		57.0	8,674		48.5
Ingestion of alcoholic drink												0.000
by the perpetrator [9,280]
Yes	749	26.1	652		19.7	811		26.3	2,212		23.8
No	2,126	74,0	2,665		80,3	2,277		73,7	7,068		76,2

				Type of violence
Characteristics
Characteristics		Physical	Psychological			Sexual		Negligence
		Physical	Psychological			Sexual		Negligence

	%	PR (CI 95%)	%	PR (CI 95%)	%	PR (CI 95%)	%	PR (CI 95%)

Sex
Female	34.9	1.00	28.8	1.00	48.4	1.00	41.3	1.00
Male	42.7	1.22 (1.16-1.28)	20.9	0.72 (0.68-0.77)	22.7	0.47 (0.44-0.50)	54.8	1.33 (1.27-1.39)
Race/skin color
White	36.8	1.00	25.1	1.00	36.3	1.00	43.9	1.00
Afro-descendant/	39.2	1.06 (1.00-1.13)	27.6	1.10 (1.03-1.18)	40.9	1.12 (1.06-1.19)	44.2	1.01 (0.96-1.06)
mulatto
Indigenous	37.0	1.00 (0.79-1.27)	27.5	1.10 (0.83-1.45)	44.7	1.23 (0.99-1.52)	40.3	0.92 (0.73-1.15)
Age bracket (years)
0 to 1	37.6	1.00	12.9	1.00	11.3	1.00	67.8	1.00
2 to 5	33.5	0.89 (0.83-0.95)	24.3	1.88 (1.71-2.07)	44.9	3.97 (3.62-4.36)	44.6	0.66 (0.63-0.69)
6 to 9	44.9	1.19 (1.12-1.27)	38.2	2.95 (2.69-3.23)	52.3	4.63 (4.22-5.08)	28.4	0.42 (0.39-0.44)
Occurrence in the
home
No	37.5	1.00	20.1	1.00	28.1	1.00	53.0	1.00
Yes	38.0	1.01 (0.95-1.08)	28.2	1.40 (1.29-1.53)	38.8	1.38 (1.29-1.48)	44.9	0.85 (0.80-0.89)
Parents^a as
pepetrators
No	43.6	1.00	26.5	1.00	53.7	1.00	25.7	1.00
Yes	33.3	0.76 (0.73-0.80)	24.0	0.90 (0.85-0.96)	20.0	0.37 (0.32-0.40)	66.7	2.60 (2.47-2.74)
Repeated violence
No	39.5	1.00	16.8	1.00	31.2	1.00	45.5	1.00
Yes	41.9	1.06 (1.00-1.13)	44.1	2.62 (2.42-2.84)	45.0	1.44 (1.35-1.54)	35.8	0.79 (0.74-0.84)
Ingestion of
alcoholic drink by
the perpetrator
No	35.9	1.00	22.1	1.00	33.8	1.00	46.2	1.00
Yes	49.0	1.36 (1.27-1.47)	42.5	1.92 (1.77-2.10)	35.8	1.06 (0.97-1.15)	37.8	0.82 (0.76-0.89)

Characteristics					Type of violence
Characteristics		Physical		Psychological			Sexual		Negligence
		Physical		Psychological			Sexual		Negligence

	%	PR (CI 95%)	%		PR (CI 95%)	%	PR (CI 95%)	%	PR (CI 95%)

Region
Mid-West	29.1	1.00	18.6		1.00	26.4	1.00	59.6	1.00
North	39.3	1.35 (1.20-1.52)	44.1		2.37 (2.08-2.71)	72.1	2.73 (2.45-3.04)	20.2	0.34 (0.30-0.39)
Northeast	41.2	1.42 (1.28-1.57)	24.2		1.30 (1.14-1.49)	33.1	1.25 (1.12-1.40)	51.9	0.87 (0.80-0.94)
Southeast	43.2	1.49 (1.36-1.63)	20.4		1.09 (0.97-1.23)	37.1	1.40 (1.28-1.55)	47.4	0.80 (0.74-0.85)
South	33.1	1.14 (1.03-1.26)	30.0		1.61 (1.43-1.82)	31.2	1.18 (1.06-1.31)	48.7	0.82 (0.76-0.88)

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[1] Collaborators DC Malta, SMM Rates and EM Melo participated in the study conception and design, data analysis and interpretation, writing of the first version of the manuscript and critical revision and approved the version to be published. MDM Mascarenhas participated in the study conception and design, data analysis and critical revision and approved the version to be published.