In their study of Kenyan infants and children, Dr Berkley and colleagues1 found that respiratory syn-cytial virus (RSV) was the most common respiratory virus among children with severe community-acquired pneumonia (CAP); non-RSV viruses made a minor contribution to the disease burden. The median age of the patients was 9.0 months (interquartile range, 3.0-20.0 months), and severe CAP was diagnosed solely based on clinical grounds recommended by the World Health Organization (WHO). We believe that despite using international guidelines designed to assess childhood death attributable to CAP in poor-resource settings, the methods used in this study biased the results.
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