Abstract Pneumonia is a major cause of morbidity and mortality worldwide, particularly among children in developing countries, where half of the pneumonia related deaths occur less than one year of age. Use of the World Health Organization guidelines is associated with a sensitivity of about 70% to 74% and a specificity of 40% to 70% in correctly identifying pneumonia confirmed on the chest x-ray. Thus to improve sensitivity and specificity, other diagnostic tests (chest Xray,laboratory test) have been employed with variable rates of accuracy. The ideal surrogate marker for pneumonia should be accurate, minimally invasive, and readily available.