Violence against women in Tunisia: Post-traumatic stress disorder and COVID-19 pandemic impact

Introduction: The pandemic caused by COVID-19 has been an exceptional universal social, psychological and health emergency. Quarantine measures adopted to contain this infection may prompt episodes of aggressionspecially against women who are already victims of violence. The Aim: to assessthe physical and psychological damage of violenceagainst women and to report the impact of the COVID-19 on the upsurge of this aggression in a sample of the Tunisian population. Method(s): A prospective study, including 300 women consulting the emergency department for aggression between October 2017 and October 2019. Sociodemographic data was collected, physical damage and post-traumatic stress disorder (PTSD) was evaluated. With a telephonic survey within 6 months and during the COVID-19 confinement, by an emergency physician and a psychologist, to assess the recurrence of violence and how to assist these victims. Result(s): The average age was 36 +/- 10 years, 35% had a university degree. Physical, verbal and sexual abuse were reported respectively in 95%, 92% and 2%of the cases. Women suffered from high rate of PTSD (35 +/- 20 SD), 38% required psychiatric follow-up and 10% required social assistance from women's protection associations. The average number of sick leave days was 10 +/- 5. After 6 months 17% are still abused. A significant increase in domestic violence during the current pandemic was reported (p < 0.01; OR = 5; CI [1.02;20.19]). Conclusion(s): Violence against women is a global public health problem. It takes many different forms and leads to significant physical and psychological consequences. Forced home isolation to contain COVID-19 infections in Tunisia has increase the domestic violence.