Child Homicide Perpetrators Worldwide: Paediatrics Open a Systematic Review
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Open Access Original article bmjpo: first published as 10.1136/bmjpo-2017-000112 on 11 August 2017. Downloaded from BMJ Child homicide perpetrators worldwide: Paediatrics Open a systematic review Heidi Stöckl,1 Bianca Dekel,2 Alison Morris-Gehring,1 Charlotte Watts,1 Naeemah Abrahams2 To cite: Stöckl H, Dekel B, ABSTRACT Morris-Gehring A, et al. Objective This study aims to describe child homicide What is already known on this topic? Child homicide perpetrators perpetrators and estimate their global and regional Child homicide is the most extreme form of violence worldwide: a systematic proportion to inform prevention strategies to reduce child ► review. BMJ Paediatrics Open against children and a tragic event with serious homicide mortality worldwide. 2017;1:e000112. doi:10.1136/ effects on families and the community. Design A systematic review of 9431 studies derived bmjpo-2017-000112 Approximately 95 000 child are murdered each from 18 databases led to the inclusion of 126 studies ► year globally (UNICEF 2014), and being murdered Additional material is after double screening. All included studies reported a ► in childhood is strongly associated with age, gender published online only. To view number or proportion of child homicides perpetrators. 169 and geography. please visit the journal online countries and homicide experts were surveyed in addition. In many settings, homicide data are incomplete, and (http:// dx. doi. org/ 10. 1136/ The median proportion for each perpetrator category was ► information on the victim–perpetrator relationship is bmjpo- 2017- 000112). calculated by region and overall and by age groups and lacking, seriously limiting the evidence base needed sex. for devising effective prevention strategies. Received 29 May 2017 Results Data were obtained for 44 countries. Overall, Revised 26 June 2017 parents committed 56.5% (IQR 23.7–69.6) of child Accepted 29 June 2017 homicides, 58.4% (0.0–66.7) of female and 46.8% (14.1– 63.8) of male child homicides. Acquaintances committed What this study hopes to add? 12.6% (5.9–31.3) of child homicides. Almost a tenth (9.2% (IQR 0.0–21.9) of child homicides had missing information ► Children face the highest risk of homicide by parents, on the perpetrator. The largest proportion of parental followed by acquaintance. homicides of children was found in high-income countries ► The limited availability of data on victim perpetrator relationships of child homicides in many regions, (64.2%; 44.7–71.8) and East Asia and Pacific Region http://bmjpaedsopen.bmj.com/ (61.7%; 46.7–78.6). Parents committed the majority even within countries with well-established (77.8% (61.5–100.0)) of homicides of children under the homicide monitoring systems, is concerning. age of 1 year. For adolescents, acquaintances were the main group of homicide perpetrators (36.9%, 6.6–51.8). There is a notable lack of studies from low-income and Children aged 15–19 years constitute 57% of middle-income countries and children above the age of 1 the global child homicides, followed by chil- year. dren under the age of 5 years (20%).1 The Conclusion Children face the highest risk of homicide majority of child homicide victims (90%) live by parents and someone they know. Increased investment in low-income and middle-income countries, into the compilation of routine data on child homicide, with the highest child homicide rates found 1 and the perpetrators of this homicide is imperative for in Latin America. The risk of homicide is on 4 May 2018 by guest. Protected copyright. understanding and ultimately reducing child homicide particularly high for boys, who account for mortality worldwide. 70% of all child homicides and for whom Trial registration number PROSPERO registration number: CRD42015030125. homicide rates dramatically increase in late adolescence.1 Evidence beyond the mere prevalence of child homicide, the sex and age of the victims however remains sparse. INTRODUCTION In general, homicides are likely to be Child homicide is the most extreme form under-reported, particularly in countries with of violence against children and a tragic poor monitoring systems and suffering from 1 London School of Hygiene and event with serious effects on families and the conflict. In many settings, homicide data is Tropical Medicine, London, UK 2 community. Approximately 95 000 child are often incomplete, and information on the South African Medical Research 1 Council, Cape Town, South Africa murdered each year globally, and the risk victim–perpetrator relationship is lacking, of being murdered in childhood is strongly seriously limiting the evidence base needed Correspondence to associated with age, gender and geography. for devising effective prevention strategies. Dr Heidi Stöckl; heidi. stoeckl@ The distribution of child homicides by age is Existing studies on child homicide perpetra- lshtm. ac. uk U-shaped and skewed towards adolescence. tors often focus on a particular age group or Stöckl H, et al. BMJ Paediatrics Open 2017;1:e000112. doi:10.1136/bmjpo-2017-000112 1 Open Access type of homicide, for example, filicide or neonaticides; bmjpo: first published as 10.1136/bmjpo-2017-000112 on 11 August 2017. Downloaded from Box 1 Detailed search terms are restricted to high income countries; or rely on small sample sizes or outdated data.2–5 This systematic review ► (‘perpetrators’ or ‘perpetrator’ or ‘offender’ or ‘offenders’ or presents a synthesis of existing global data to describe ‘aggressor’ or ‘aggressors’ or ‘father’ or ‘fathers’ or ‘mother’ or child homicide perpetrators and to estimate their global ‘mothers’ or ‘parent’ or ‘parents’ or ‘brother’ or ‘brothers’ or ‘sister’ and regional proportion. or ‘sisters’ or ‘aunt’ or ‘aunts’ or ‘uncle’ or ‘uncles’ or ‘grandmother’ or ‘grandmothers’ or ‘grandfather’ or ‘grandfathers’ or ‘grandparent’ or ‘grandparents’ or ‘stranger’ or ‘strangers’ or ‘acquaintance’ or ‘acquaintances’ or ‘friends’ or ‘friend’ or ‘partner’ or ‘partners’ or METHODS ‘victim-offender relationship’ or ‘victim offender relationship’ or Our systematic review was conducted in accordance with ‘victim-offender relationships’ or ‘victim offender relationships’ or ‘ex-partners’ or ‘ex-partner’ or ‘husband’ or ‘husbands’ or ‘wife’ PRISMA guidelines6 and registered at PROSPERO (Regis- or ‘wives’ or ‘couple’ or ‘couples’ or ‘boyfriend’ or ‘girlfriend’ or tration number: CRD42015030125) on 9 December ‘spouse’ or ‘spouses’ or ‘lover’ or ‘spousal’ or ‘boyfriends’ or 2015. To obtain representative data on the victim– ‘girlfriends’ or ‘relative’ or ‘relatives’ or ‘family member’ or ‘family offender relationship of child homicides, we searched members’ or ‘maternal’ or ‘parental’) the following databases and electronic resources from ► AND (‘siblicide’ or ‘neonaticide’ or ‘Infanticide’ or ‘fratricide’ or first record to the 25 April 2017: Medline, Global Health, ‘victim-perpetrator relationship’ or ‘victim perpetrator relationship’ Embase, PsycINFO, Social Policy, Popline, Pubmed, Web or ‘sororicide’ or ‘family homicide’ or ‘familicide’ or ‘filicide’ or of Science, LILACS, Medcarib, ADOLEC, Cumulative ‘fratricides’ or ‘family murder’ or ‘family homicide suicide’ or Index to Nursing and Allied Health Literature, Biosis ‘familicy’ or ‘family suicide’ or ‘fatal child abuse’ or ‘infant baby Citation index, KCI-Korean Journal Database, SciELO dumping’ or ‘child abuse murders’ or ‘child abuse fatalities’ or citation Index, Western Pacific Region Index Medicus, ‘child abuse fatality’ or ‘parental homicide’ or ‘parental homicides’ or ‘parents who kill’ or ‘mothers who kill’ or ‘fathers who kill’ or Index Medicus for the WHO Eastern Mediterranean ‘grandparents who kill’ or ‘uncles who kill’ or ‘siblings who kill’ or Region and International Bibliography of Social Sciences ‘aunts who kill’ or ‘brothers who kill’ or ‘sisters who kill’ or ‘family IBSS. Controlled vocabulary terms specific to each murder’ or ‘family killing’ or ‘adolescent homicide’ or ‘adolescence database were used. For each database, terms included homicide’ or ‘adolescent murder’ or ‘adolescence murder’ or those designed to capture ‘child homicide’ and, where ‘adolescent killing’ or ‘adolescence killing’ or ‘child murder’ or ‘child possible, terms to capture perpetrators and to exclude homicide’ or ‘child killing’ or ‘children murder’ or ‘children killing’ or non-relevant article types, such as commentaries. The ‘children homicide’ or ‘sibling murder’ or ‘sibling killing’ or ‘sibling search strategy is displayed in box 1. homicide’ or ‘infant murder’ or ‘infant killing’ or ‘infant homicide’ or Studies were eligible for inclusion if they stated a number ‘toddler killing’ or ‘toddler murder’ or ‘toddler homicide’ or ‘young or proportion of children murdered by distinctly stated adult murder’ or ‘young adult killing’ or ‘young adult homicide’ http://bmjpaedsopen.bmj.com/ perpetrator(s). The definition of homicide followed the or ‘sister murder’ or ‘sister killing’ or ‘sister homicide’ or ‘brother murder’ or ‘brother homicide’ or ‘brother killing’ or ‘boy murder’ definitions used in the individual papers or official statis- or ‘boy killing’ or ‘boy homicide’ or ‘girl murder’ or ‘girl killing’ or tics. The sample could be based on a country, province ‘girl homicide’ or ‘child abandonment’ or ‘infant abandonment’ or or town and be derived from national databases, national ‘toddler abandonment’ or ‘girl abandonment’ or ‘baby abandonment’ representative studies, police, court, mortuary or prison or ‘homicide death rates in childhood’ or ‘unnatural sudden