In a study conducted in South Africa and published this year, viral pathogens were found in 78% of children <5 years of age with ALRIs.  As expected, the most common viruses were rhinovirus (37%), respiratory syncytial virus (RSV) (26%), adenovirus (26%) and influenza virus (7%).
These figures highlight the urgent need for effective interventions against respiratory syncytial and influenza viruses, not only to reduce mortality but also hospital admissions from ALRIs. RSV infection is the major cause of ALRI globally and of morbidity especially in infants <1 year of age  and those with underlying chronic diseases or a history of prematurity.
Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low- and middle-income countries: A systematic review and meta-analysis of observational studies.
We know of only one previous investigation of ALRI in relation to stove type in Nepal.
This case-control study was conducted in an area of Nepal with a balanced distribution of primary cookfuel types--electricity, liquified petroleum gas (LPG), kerosene, and biomass--with the primary objective of investigating the relationships of cookfuel types to ALRI and estimating population-attributable fractions.
Eligibility included confirmation that the child did not have ALRI and application of the same exclusion criteria as for cases.
With the exception of the study by Wesley and Loening, (31) all of those published showed positive associations between indoor air pollution and child ALRIs. The majority of studies reported ORs between 1.88 and 3.5, comparable with other studies in developing countries (ORs 2-3).
Three health outcomes had strong evidence of a causal relationship: ALRIs in children under 5 years, and COPD and lung cancer (from the use of coal) in adults of 30 years and older.
Overall in South Africa in 2000, about 24% of the burden from ALRIs in children under 5 years was attributable to indoor air pollution from household use of solid fuels.
With respect to indoor air pollution, the assessment included only ALRI, COPD, and lung cancer (from coal use)--those health outcomes for which the evidence for indoor air pollution as a cause was classified as strong.
This implies that the CRA may have slightly overestimated the global burden of disease caused by indoor air pollution-attributable ALRI, COPD, and lung cancer.
(2004) found a relative ALRI risk of 2.3 (95% CI, 1.9-2.7) among children exposed to indoor air pollution.