Prevalence and Patterns of Sexual Assault Among Female Victims in Madhya Pradesh, India: A Five-Year Retrospective Descriptive Study

Background: Sexual violence remains a serious public-health and medico-legal concern in India. There is limited state-wide published data describing patterns of reported sexual assault in Madhya Pradesh (India). This five-year retrospective descriptive study was undertaken to estimate the prevalence, describe victim and assault characteristics, and summarize key forensic findings among cases reported to health-care and police services between 2018 and 2022. Materials and Methods: We performed a retrospective study of medico-legal registers, forensic examination records and corresponding police First Information Reports from multiple tertiary and district hospitals across the state for the period 1 January 2018 to 31 December 2022. Extracted variables included victim demographics (age, sex, residence, marital status), assault circumstances (year, location, relationship to perpetrator, time to reporting), and clinical/forensic findings (genital and extra-genital injuries, pregnancy test, forensic specimen collection and laboratory results). Data were entered into a coded database and analysed using descriptive statistics (means/medians, proportions) and bivariate tests (chi-square for categorical variables; Mann–Whitney U or Kruskal–Wallis for non-parametric comparisons). Statistical significance was set at p<0.05. Institutional ethics approval was obtained prior to data collection. Results: A total of 18,718 reported cases were identified over five years. Annual counts showed a decline in 2020 with partial recovery in 2021–2022. Females comprised the overwhelming majority of victims (>95%). Minors (<18 years) accounted for approximately 60% of cases. Median delay from incident to presentation was 5 days (IQR 2–15); only about one-third presented within 24 hours. In 85% of cases the perpetrator was known to the victim. Acute genital injuries were documented in roughly 25–30% of survivors; extra-genital physical injury was less common (~10%). Forensic specimens were obtained in a minority of cases and biological confirmation of semen/spermatozoa was infrequent. Delayed reporting was significantly associated with lower rates of positive forensic findings (p<0.01). Conclusion: Reported sexual assaults in the study period disproportionately affected young, unmarried females and children, and were most often perpetrated by known persons. Long delays in reporting reduced opportunities for successful forensic evidence recovery. Strengthening community awareness, improving access to timely medico-legal services, and standardizing forensic sample collection are essential to improve care, documentation and legal outcomes.