Patterns of child sexual assault in Laghouat, Algeria: a hospital-based forensic study (2017–2024)

Child sexual assault constitutes a major public health and medico-legal challenge worldwide, particularly in socio-cultural contexts where disclosure is limited and underreporting is widespread. In Algeria, social stigma, fear of family dishonor, and cultural silence substantially hinder detection, reporting, and appropriate medico-legal management of sexual violence involving minors. This study aimed to describe the epidemiological, socio-economic, and medico-legal characteristics of reported child sexual assault cases in Laghouat and to explore factors associated with delayed medico-legal consultation in a hospital-based setting. A retrospective, record-based review was conducted in the Forensic Medicine Department of Laghouat Hospital between January 2017 and June 2024. Data were extracted from medico-legal consultation registers and forensic expert reports concerning sexual assault cases involving individuals under 18 years of age. Descriptive statistics and exploratory analyses were performed using SPSS software. Among 19,180 medico-legal consultations, 14,592 (76.0%) involved assault cases, including 126 cases of sexual assault against minors (0.66% of all consultations and 8.96% of assault cases). Most victims were adolescents aged 13–17 years, with a predominance of male victims in this clinical setting. In 82.5% of cases, perpetrators were known to the victims, most commonly neighbors or acquaintances. Assaults frequently occurred in secluded public or semi-public settings and were rarely associated with severe physical violence or life-threatening injuries. The majority of victims (79%) presented more than 72 h after the assault, limiting forensic evidence recovery and post-exposure prophylaxis. Delayed consultation was associated with rural residence, family hesitation, and low parental employment status. Indicators of socioeconomic vulnerability, including household poverty, parental unemployment, and overcrowded living conditions, were frequently observed. Child sexual assault in southern Algeria predominantly affects socioeconomically vulnerable adolescents and is characterized by substantial delays in medico-legal consultation. These findings underscore the need to strengthen integrated public health and judicial responses focusing on prevention, early disclosure, professional training, psychosocial support, and reinforced child protection systems.