A case of severe respiratory illness, referred to as pneumonia, was defined as self-reported cough and difficulty breathing for two or more days, or a physician-diagnosis of pneumonia; the reference period was the 12 months prior to the interview. This case definition has been used in several studies of self-reported pneumonia in the community [12, 14] and is based on questions that were moderately sensitive and specific for pneumonia from a World Health Organization verbal autopsy questionnaire. [15] Additionally, severe pneumonia was defined for children <3 years old who met the pneumonia case definition as any of the following: blue lips and/ or nails, inability to breastfeed or drink, convulsions, unconsciousness or decreased activity. For those ≥3 years old who met the pneumonia case definition, severe pneumonia was defined as fast breathing with confusion.