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Child AbuseNCT04117971

Knowledge, Attitude and Practice of Child Abuse Diagnosis and Reporting Among a Group of Egyptian Dentists

An observational study of Child Abuse, run by Cairo University at 1 site in Egypt.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Child abuse is defined as "Any act of commission or omission that endangers or impairs child's physical, sexual, or emotional health and development". According to The Centres for Disease Control and Prevention (CDC), Child physical abuse CPA is defined as "The intentional use of physical force against a child that… Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Child Abuse
What is being tested?
Questionnaire
How many people
196 participants
Where
1 siteEgypt
Study dates
1 Nov 2020to 1 May 2021
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: Cluster sample, involving dentists with different experience, knowledge, age group, and specialities.

Who may be able to join

  • Staff members at all departments in Faculty of Dentistry, Cairo University.
  • Master's and PhD candidates enrolled at different specialities.

Who cannot join

  • Intern dentists.
  • Dentists who don't have a work permission in Egypt.
  • Dentists who will refuse to participate.

Trial locations and contacts

1 site in 1 country.

Egypt1 site
  • Cairo University

    Cairo, 12613

Other trials in Egypt

About this study

Official title: Knowledge, Attitude and Practice of Child Abuse Diagnosis and Reporting Among a Group of Egyptian Dentists: A Cross Sectional Study

Child abuse is defined as "Any act of commission or omission that endangers or impairs child's physical, sexual, or emotional health and development". According to The Centres for Disease Control and Prevention (CDC), Child physical abuse CPA is defined as "The intentional use of physical force against a child that result in, or has the potential to result in, physical injury".

Child abuse and neglect may occur in any family, and it isn't confined to certain geographic, ethnic, or socioeconomic background. According to World Health Organization (WHO) estimation, around forty million children suffer from different forms of abuse, and require health and social care.

Read more

WHO has estimated that in year 2000 nearly fifty-seven thousand children under fifteen years old were dead because of abuse, with the highest rate in children between zero to four years old. In 2014, WHO estimated that 23% of children worldwide were subjected to physical abuse.

Dentists are the best to detect children who are at abuse risk, since more than fifty percent of abuse injuries occur at head and neck region, and they are the first to see and treat orofacial region. Studies have shown that while dentists are in a good position to detect and report abuse, few of them do report abuse cases.

The main causes of not reporting CPA are lack of adequate history, inability, and hesitancy in diagnosing the abuse, fear that it may affect the reputation of their clinic, worry about what will happen to the child and his family, and unfamiliarity with child protection policy in their workplace.

The Egyptian law obligates dentists to report any suspected case of child abuse. Many studies have been published assessing dentists' knowledge and practice of CPA diagnosis and reporting. However, to our knowledge, there are no published data available about Egyptian dentists' cognition of CPA signs and diagnosis, and their actual participation in reporting suspected cases.

Read the detailed description

Infants and young children are easy targets for abuse. Their challenging behaviour, defencelessness, physical weakness, and inability to escape from angry parent. They are also very young, and may not even know how to describe the injury cause. This adds additional burden to the dentist to diagnose and report such cases.

The damage that will inflict upon the child whether it is developmental, physical or mental will depend mainly on the child's age, and the scope of the abuse. The intervention to protect children isn't the responsibility of a single institute or profession, it's a shared community duty.

Risk factors for child to be subjected to abuse depend mainly on age and sex. Younger children are at greater risk for physical abuse, while older children who reached adolescence are subjected more to sexual abuse. Boys are victims of beating or physical punishment, while girls are subjected to infanticide, sexual abuse, educational and nutritional neglect. Other risk factors include poverty, being raised by single parent or very young parents, and presence of other violent relationship at home.

Studies have shown that orofacial injuries are common in case of physical abuse. From fifty to seventy-seven percent of abused children had suffered from orofacial injuries. This high percent to the head, face, and neck regions enhances the theory that easy accessibility and psychological importance of these area make them frequent target to the abuser.

Orofacial injuries due to physical abuse may include bruising, contusion, abrasions or laceration to soft tissue, dental fractures and dislocation, dental avulsion, maxillary and mandibular fractures. Skin injuries include ecchymosis and excoriations, which are commonly associated with abrasions, contusions or lacerations. These injures may be produced by natural ways like fists or slaps, instruments like household utensils, and ligature instruments like belts and shoelace.

Since orofacial injuries is common in case of CPA, and dentists are the first to examine this area, they are in better place to diagnose and report such cases. In addition to that, children who are subjected to abuse or neglect have higher incidence of caries and other oral diseases.

A study compared oral health between three groups: Children who witnessed violence or are victims of abuse, children with eating disorders, and control group, found that incidence of caries and periodontal diseases are higher in children in the abuse group than the other two groups.

Abusive parents avoid going to the same paediatrician in order not to be detected, but they feel that dentists represent less threat to them. And as dentists are in perfect position to diagnose and report CPA, their knowledge and attitude toward reporting are essential factors to fulfil their legal and ethical obligation.

Unfortunately, large portion of CPA cases are undocumented and unreported. This in addition to, high prevalence of CPA, and deficient statistics that only rely on police and social workers reports, has changed some countries policies. In America, any close contact to the child like teachers and health care workers must report suspected cases. In Europe even normal citizen can report such cases.

In a recent study navigating experience of dental professionals in UK, there was a remarkable gap between diagnosing CPA and reporting it. While 67% suspected abuse during their career, only 29% made a child protection referral. The under-reporting of CPA is also an international issue.

Although failing to diagnose cases of child physical abuse may lead to catastrophic events, dentists should be trained to know benign conditions that may be mistaken for child abuse; so that unnecessary distress is avoided. It was found that dentists who joined professional training problem can differentiate between cases of abuse and accidental injury, they were also better at discussing this sensitive topic with the parents.

The result of this study will enhance the importance of adding child abuse diagnosis and reporting methods, physical and behavioural indicators of child abuse, as well as techniques of history taking and documentation of suspected cases to pregraduate and postgraduate curriculums, increasing the dentists' awareness about their legal and ethical obligation to report suspected abuse cases. It will also help in identifying barriers to reporting CPA, and assessing dentists' training needs to make the dentists actively involved in child protection.

Conditions
Child Abuse
Being tested
Questionnaire
Keywords
Child abuse, Abuse diagnosis, Abuse report, dentists' knowledge

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • QuestionnaireOther

    The study will involve structured questionnaire asking questions about knowledge, attitude, and practice of child abuse diagnosis and reporting among dentists.

Study groups in NCT04117971
Study groupRoleWhat they receive
Staff membersStaff members in different clinical departments at Faculty of Dentistry, Cairo University.
Receives: Other: Questionnaire
PhD studentsPhD candidates in different clinical departments at Faculty of Dentistry, Cairo University.
Receives: Other: Questionnaire
Master's studentsMaster's candidates in in different clinical departments at Faculty of Dentistry, Cairo University.
Receives: Other: Questionnaire

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Assessing Egyptian dentists' knowledge about child abuse diagnosis.

    Questions about the ability of dentist to diagnose abuse, using trichotomous scale (Yes/No/Don't know)

    Measured: One month.

  2. Assessing Egyptian dentists' knowledge about child abuse reporting.

    Questioning if the dentist is able to report a suspected case of child abuse, using trichotomous scale (Yes/No/Don't know)

    Measured: One month.

  3. Assessing Egyptian dentists' attitude and practice towards child abuse.

    Assessment of Egyptian dentists' attitude towards child abuse reporting, and practice of reporting, using trichotomous scale (Yes/No/Don't know)

    Measured: One month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Oct 2019
  2. Study start1 Nov 2020
  3. Primary completion1 May 2021
  4. Study completion1 May 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Cross-sectional
Enrolment
196 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04117971
Sponsor's protocol ID
14422017451433
Status last verified
Mar 2023
First submitted
4 Oct 2019
Last updated
2 Mar 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Al-Dabaan R, Newton JT, Asimakopoulou K. Knowledge, attitudes, and experience of dentists living in Saudi Arabia toward child abuse and neglect. Saudi Dent J. 2014 Jul;26(3):79-87. doi: 10.1016/j.sdentj.2014.03.008. Epub 2014 May 9.

    PubMed 25057227
  • Costacurta M, Benavoli D, Arcudi G, Docimo R. Oral and dental signs of child abuse and neglect. Oral Implantol (Rome). 2016 Jul 25;8(2-3):68-73. doi: 10.11138/orl/2015.8.2.068. eCollection 2015 Apr-Sep.

    PubMed 27555907
  • Harris JC, Elcock C, Sidebotham PD, Welbury RR. Safeguarding children in dentistry: 1. Child protection training, experience and practice of dental professionals with an interest in paediatric dentistry. Br Dent J. 2009 Apr 25;206(8):409-14. doi: 10.1038/sj.bdj.2009.307.

    PubMed 19396200
  • Owais AI, Qudeimat MA, Qodceih S. Dentists' involvement in identification and reporting of child physical abuse: Jordan as a case study. Int J Paediatr Dent. 2009 Jul;19(4):291-6. doi: 10.1111/j.1365-263X.2009.00971.x. Epub 2009 May 20.

    PubMed 19476516
  • Cairns AM, Mok JY, Welbury RR. Injuries to the head, face, mouth and neck in physically abused children in a community setting. Int J Paediatr Dent. 2005 Sep;15(5):310-8. doi: 10.1111/j.1365-263X.2005.00661.x.

    PubMed 16128994
  • Jordan A, Welbury RR, Tiljak MK, Cukovic-Bagic I. Croatian dental students' educational experiences and knowledge in regard to child abuse and neglect. J Dent Educ. 2012 Nov;76(11):1512-9.

    PubMed 23144487
  • Kirankumar SV, Noorani H, Shivprakash PK, Sinha S. Medical professional perception, attitude, knowledge, and experience about child abuse and neglect in Bagalkot district of north Karnataka: a survey report. J Indian Soc Pedod Prev Dent. 2011 Jul-Sep;29(3):193-7. doi: 10.4103/0970-4388.85807.

    PubMed 21985873
  • Laud A, Gizani S, Maragkou S, Welbury R, Papagiannoulis L. Child protection training, experience, and personal views of dentists in the prefecture of Attica, Greece. Int J Paediatr Dent. 2013 Jan;23(1):64-71. doi: 10.1111/j.1365-263X.2012.01225.x. Epub 2012 Mar 16.

    PubMed 22429739
  • Mogaddam M, Kamal I, Merdad L, Alamoudi N. Knowledge, attitudes, and behaviors of dentists regarding child physical abuse in Jeddah, Saudi Arabia. Child Abuse Negl. 2016 Apr;54:43-56. doi: 10.1016/j.chiabu.2016.02.004. Epub 2016 Mar 15.

    PubMed 26990176
  • Sonbol HN, Abu-Ghazaleh S, Rajab LD, Baqain ZH, Saman R, Al-Bitar ZB. Knowledge, educational experiences and attitudes towards child abuse amongst Jordanian dentists. Eur J Dent Educ. 2012 Feb;16(1):e158-65. doi: 10.1111/j.1600-0579.2011.00691.x. Epub 2011 May 5.

    PubMed 22251340
  • Ellis C. Summary of: the Scottish dental practitioner's role in managing child abuse and neglect. Br Dent J. 2013 May;214(9):454-5. doi: 10.1038/sj.bdj.2013.461. No abstract available.

    PubMed 23660905
  • Harris CM, Welbury R, Cairns AM. The Scottish dental practitioner's role in managing child abuse and neglect. Br Dent J. 2013 May;214(9):E24. doi: 10.1038/sj.bdj.2013.435.

    PubMed 23660928

Questions about this trial

What is this clinical trial studying?

An observational study of Child Abuse, run by Cairo University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Assessing Egyptian dentists' knowledge about child abuse diagnosis. (time frame: One month.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04117971, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Mar 2023.

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