%0 Journal Article
%T From Caseload to Health System Change: Patterns and Outcomes of Pediatric ENT Emergencies in Burundi
%A Lionel Horugavye
%A Gordien Ngendakuriyo
%A Sixte Nderagakura
%A Octave Murisho
%A Josu¨¦ Ndayishemeze
%A Pierre Nkunzimana
%J Open Access Library Journal
%V 12
%N 12
%P 1-18
%@ 2333-9721
%D 2025
%I Open Access Library
%R 10.4236/oalib.1114678
%X <strong>Background:</strong> Pediatric ENT emergencies are high-acuity presentations that require rapid intervention. In low-resource settings, they expose system fragilities, limited pediatric airway capacity, inequitable access, and high empirical antibiotic use, yet data from Burundi remain scarce. <strong>Objective:</strong> To analyze epidemiological patterns, etiologies, access inequities, management pathways, and antibiotic exposure among pediatric ENT emergencies at CHUK and derive feasible system-oriented reforms. <strong>Methods:</strong> Retrospective review of 651 pediatric ENT emergency cases (0 - 15 years) at CHUK from January 2018 to December 2019. Variables included sociodemographic features, geographic origin, symptoms, diagnoses, severity category, management, and outcomes. Fisher¡¯s exact test assessed associations between age and etiology. Antibiotic use was evaluated relative to WHO AWaRe steward-ship principles. <strong>Results:</strong> Pediatric ENT emergencies accounted for 10.73% of all ENT consultations. Children &lt; 5 years constituted 70.81% (mean age 4.08 years). Urban residence dominated (61.14% from Bujumbura Mairie). Peak presentations occurred in March and June. Etiologies were infectious (45.01%), foreign bodies (42.55%), traumatic/hemorrhagic (10.14%), malformative (0.92%), functional (0.92%), and tumoral (0.46%). Absolute emergencies (9.52%) were chiefly tracheo-bronchial foreign bodies (51.61%) and acute laryngitis (20.97%). Antibiotics were prescribed in 91.37% of all cases, including many non-infectious presentations. Outcomes were favorable in 19.35%; complications occurred in 2.31%; no deaths occurred; outcomes were undocumented in 78.19%. <strong>Conclusion: </strong>Pediatric ENT emergencies at CHUK are frequent, preventable, age-concentrated, and inequity-skewed. The high rate of non-indicated antibiotic use reflects systemic uncertainty rather than clinical need. Standardized triage training, district-level airway management capabilities, caregiver foreign-body prevention programs, and WHO AWaRe-aligned antibiotic stewardship can significantly reduce morbidity while preserving antimicrobial effectiveness.<br />
%K Pediatrics
%K Otorhinolaryngology
%K Emergencies
%K Foreign Body Aspiration
%K Antimicrobial Stewardship
%K Health Equity
%K Low-Resource Settings
%K Burundi
%U http://www.oalib.com/paper/6881830