"Acute lower respiratory infection (ALRI) continues to be one of the leading causes of morbidity and mortality in children younger than 5 years across the globe. However, significant challenges remain in determining the epidemiology and aetiology of, and risk factors for, ALRI, severe ALRI, and death. These challenges include addressing a number of biases in clinical diagnosis (with variable clinical and radiological definitions of ALRI), microbiological diagnosis (with known insensitivity of bacterial blood culture and nasopharyngeal viral immunofluorescence and culture, and increased sensitivity but reduced specificity by PCR analyses of nasopharyngeal specimens), and case and control ascertainment in the hospital and community."

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