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The role of HIV infection in acute respiratory infections among children in sub-Saharan Africa.

Acute respiratory infections (ARI) are responsible for 1.9 million deaths annually, or 20% of the total worldwide under 5-year mortality rate. Developing countries carry the major burden of these deaths. In sub-Saharan Africa, human immunodeficiency virus type 1 (HIV-1) plays a significant role in this high mortality rate. The clinical and radiological features of ARI in HIV-infected and non-infected children are similar, with few exceptions. Epidemiological mapping of aetiological agents is essential to develop standard case management guidelines. The role of newer cytokines (e.g., procalcitonin) in establishing aetiology requires further evaluation. Implementation of antiretroviral therapy, chemoprophylaxis and vaccination programmes for HIV-infected children will have a favourable impact on the huge burden of ARI in developing countries. Governmental and nongovernmental organisations must provide the financial and human resources needed to overcome this enormous challenge to global lung health.