This prospective case-control study aims to evaluate the utility and establish laboratory thresholds for a multi-serotype urine antigen test for the diagnosis of pneumococcal community acquired pneumonia in children 5 years of age or younger in Guatemala.

CASES:

Inclusion Criteria:

• Age older than 1 month (31 days) and up to 71 months and 28 days.
• Diagnosis of radiologically confirmed pneumonia per WHO criteria in the ED or hospital within 48 hours of hospital admission
• Signed informed consent by parents or legal guardian to participate in the study

Exclusion Criteria:

• Known immunodeficiency
• Major congenital malformation (e.g., hemodynamically compromised congenital heart malformation or any malformation leading to recurrent pneumonia) or serious chronic disorder
• Significant neurological disorder
• Hospitalization within the previous 30 days for pneumonia or respiratory infection
• Use of parenteral antibiotics for current illness (leading to diagnosis of pneumonia)
• Transferred to the study hospital after already being hospitalized at a different location for ≥ 48 hours

CONTROLS:

Inclusion Criteria:

• Age 1 to 71 months and signed informed consent by parents or legal guardian

Exclusion Criteria:

• Known immunodeficiency
• Major congenital malformation (e.g., hemodynamically compromised congenital heart malformation or any malformation leading to recurrent pneumonia) or serious chronic disorder
• Significant neurological disorder
• Fever or suspicion of community-acquired pneumonia or other respiratory infectious disease (symptoms of cough, congestion, tachypnea, indrawing, etc.)
• Hospitalization within the previous 30 days for pneumonia or respiratory infection

Children 5 years of age or younger with either community-acquired pneumonia (cases) or health children (controls).