The present study was conducted at University Clinics in Lubumbashi; located in the city of Lubumbashi; in DR Congo. Lubumbashi is the second largest city in DR Congo, with a population around 2 million according to the latest estimates [8] . This city is organized into 7 municipalities; one of which, peripheral is urban-rural type. Lubumbashi University Clinics is a tertiary level hospital; highest level according to the health care system in DR Congo. Specialized consultations are organized in various fields, including ENT. The ENT department organizes outpatient consultations at the dispensary, and the patients requiring hospitalization are in the services of Surgery or Pediatrics according to their age. The service includes the expertise of at least one ENT specialist and general practitioners.

This is a cross-sectional and retrospective descriptive study conducted over a period of 2 years from January 2014 to December 2015.

We performed a convenience sampling, based on the inclusion criteria described below. A total of 309 cases were collected for this study.

Were included in this study, children aged less than 19 years of age during the study period, who have been seen in the ENT service, and for whom a diagnosis was documented and treatment was undertaken.

The adults and patients for whom clinical data were not available were excluded from the study.

We carried out a documentary review of the cases recorded in the registers and medical form.

The following parameters were collected: age, sex, origin, admission complaints, initial treatment, diagnosis, treatment regimen used and outcome of treatment.

The data has been encoded and analyzed with Epi-info 7, on Windows. Thus, the frequencies were generated, with their means and standard deviation.

Our study shows a frequency of 19.4% of cases of pediatric consultations. This figure coincides with that of Donkeng in Cameroon [3] , for whom children accounted for 19.4% of cases in all ENT emergencies and close to that of Seymour in Chile [7] with 21% of children under 15 years old received in an outpatient ENT consultation. Other authors have found a high frequency of outpatient consultations or ENT emergencies, 41% for Fasunla in Nigeria [2] ; 52.72% for Badou-N’Guessan in Ivory coast [4] ; 11.23% for Ramarozatovo in Madagascar [5] ; 26.8% for Choi in the United States [6] . The frequency of pediatric ENT consultations could have been higher if some cases were not directly treated in the pediatric ward of the same hospital.

It should be noted that there are three declared ENT services on the city, including the University Clinics of Lubumbashi. Yet, in common practice, most cases are treated by physicians with generalist skills. Hence the importance of an efficient care system that promotes information, sorting and referral of patients to more appropriate and certainly more specific care.

We noted in our series a female predominance with a sex ratio of 1.45. This was also the case for Seymour in Chile [7] Attifi in Guinea-Conakry [1] for all ENT consultations at all ages. Other authors have found a predominance of the male sex [2] [3] [4] [5] [6] [9] [10] [11] . Sereme in Burkina-Faso [12] found a sex ratio of 1. There is no particular reason for mentioning these differences.

In our series, the average age is 7.08 ± 5.37 years. Almost half of the cases are in the age group of children under 5 (48.8%). These findings are similar to those of other authors [4] [5] [11] Indeed, infections of the ENT sphere are common in children for morphological and functional reasons making them more vulnerable than adults [13] .

In relation to the origin of the patients, 49.8% of the cases came from the commune of Lubumbashi. It is one of the most populated municipalities of the city and the geographical situation of the University Clinics in this municipality would explain a better accessibility.

Most of the patients, 98.06%, had come for spontaneous consultation while only 1.94% had been referred. This underlines the importance of improving interdisciplinarity on the one hand, but also increasing medical staff’s awareness of the orientation of ENT cases towards the most appropriate service.

In our series, otology accounted for 67.6% of complaints followed by rhinology and laryngo-pharyngology and appendices (neck and salivary glands) with respectively 36.6% and 32.4%. Furtado in Brazil [14] also found a prevalence of otological complaints. This frequency distribution was also found in the study by José Santos De Andrade in Brazil [15] with a predominance of otology cases in all ENT emergencies of his series as well as a high frequency of ear infections. Pharyngo-esophageal emergencies were more common in the Adedeji series in Nigeria [10] . This distribution, in our series, would be due to the fact that the parents take spontaneously their children whose ears are painful or sink in the service of ENT whereas that is not generally the case for the complaints concerning the rest of the sphere ENT for which they consult most often the pediatrician or a general practitioner in the first place.

The most common complaint was earache with 39.8% of cases in otology. This is probably due to the fact that pain is one of the symptoms difficult to bear especially for children. In rhinology, clear rhinorrhea was the most common symptom with 22.0% of cases. Discomfort caused by this symptom; the desire to see it disappear as soon as possible, the fear of the occurrence of rhinosinusic complications could explain the high frequency of consultations for this complaint. Odynophagia accounted for 18.4% of the laryngology and pharyngology cases associated with the appendices. This could have an explanation similar to that of earache.

For diagnosis, the most common in our series was ear infections in 37.86% of cases. Fasunla in Nigeria [2] , José Santos Cruz de Andrade in Brazil [15] , Sahin in Turkey [16] and Kishve in India [17] also found a predominance of ear infections. Adhikari in Nepal [18] found in his study that otitis came in second place after cerumen cap. For Lalwani [19] acute otitis media is the most common infectious pathology of children with a peak frequency during the first two years of life.

In sub-specialties, otitis accounted for 37.86% of otology cases; tonsillitis 20.71% of cases in pahyno-laryngology associated with appendages and rhinitis 15.21% of cases of rhinology. Kishve in India [17] found the same distribution of the most frequent diagnoses related to sub-specialties, 31.8% otitis in otology; 38.2% rhinitis in rhinology and 42.9% tonsillitis in laryngo-pharyngology. These high figures of infectious diseases could be explained by the poor hygiene of life, self-medication, tropical climatic conditions and the high level of pollution of the city of Lubumbashi.

Initial treatment was initiated by self-medication or prescription in 58.25% of cases. This is explained in our series by the fact that parents tend to give drugs to their children without prior medical advice or to seek advice from the pharmacist who often recommends symptomatic treatment regardless of the cause. Some use a relative who is in the medical field (doctor or nurse) who advises a product without having examined the patient.

Regarding the type of treatment after ENT consultation, antibiotic therapy was instituted in 67.21% of cases; an anti-inflammatory given in 62.78% of cases. Only 1.94% of cases had surgery. The medical treatment is based on an initially probabilistic antibiotherapy instituted as soon as the patient is admitted and secondarily adapted to the results of the antibiogram [12] . This high proportion of antibiotic treatment in our series, while most children’s ENT pathologies are viral, could be explained by the fact that the majority of cases received already showed signs of bacterial superinfection. Being in a tropical zone, bacterial superinfection is found in many cases and the difficulty of access to paraclinical examinations, especially the antibiogram also justifies this antibiotic probabilistic in our environment. As patients consult for persistent symptoms, they require good symptomatic management outside of the cause, hence the high frequency of anti-inflammatory drugs. The low rate of surgery is a function of the low rate of diagnosis requiring surgical treatment, the difficulties of paraclinical confirmation of certain diagnoses, the insufficient technical platform and the difficulties of access to health care.

The treatment was ambulatory in 98.70% of the cases while 1.30% of the cases were hospitalized. Other authors have also found a predominance of outpatient treatment [3] [4] These figures can be explained by the fact that the ORL service organizes more outpatient consultations and hospitalises very few patients, particularly those who have undergone surgery and requiring parenteral treatment.

As for post-treatment outcome, healing was reported in 44.34% of cases; 55.66% of cases were lost of view and no deaths were recorded in our series. This high rate of patients lost of view may be due to the fact that patients generally do not prefer to see the doctor for a post-treatment check, assuming to be cured since no longer having any symptoms.

It should be noted that this study has encountered a few limitations. In fact, the collection of the data was carried out retrospectively, based on the archived files and registers of the patients. Therefore, we must note a lack of certain parameters that are not always included in the files. On the other hand, it is possible that there is a relative underestimation of the cases, some patients being treated directly in pediatrics. Nevertheless, despite all these limitations, we believe that the overall objectives of this study have been achieved.