Author Contributions: Dr Scott had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Cowgill, English, Newton, Feikin, Scott.
Acquisition of data: Cowgill, Ndiritu, Nyiro, Slack, Chiphatsi, Ismail, Kamau, Mwangi, Scott.
Analysis and interpretation of data: Cowgill, Ndiritu, Slack, Newton, Feikin, Scott.
Drafting of the manuscript: Cowgill, Newton, Feikin, Scott.
Critical revision of the manuscript for important intellectual content: Cowgill, Ndiritu, Nyiro, Slack, Chiphatsi, Ismail, Kamau, Mwangi, English, Newton.
Statistical analysis: Cowgill, Newton, Scott.
Obtained funding: Feikin, Scott.
Administrative, technical, or material support: Ndiritu, Nyiro, Slack, Chiphatsi, Ismail, Kamau, Mwangi, English, Scott.
Study supervision: Cowgill, Kamau, English, Newton, Feikin, Scott.
Financial Disclosures: Dr English and Dr Scott report that they coordinate the Network for Surveillance of Pneumococcal disease in the East African Region, which is funded by the Accelerated Development and Introduction Plan for Pneumococcal Vaccines but which has also received an unrestricted gift from GlaxoSmithKline to support 3 annual conferences of the network partners. No other authors reported financial disclosures.
Funding/Support: The surveillance arose from clinical and epidemiologic work supported by the Kenya Medical Research Institute (KEMRI), the Wellcome Trust of Great Britain, and the US Agency for International Development. Dr English and Dr Scott were supported by Wellcome Trust career development fellowships (050563 and 061089, respectively) and Dr Newton by a senior fellowship in clinical tropical medicine (050533).
Role of the Sponsor: The funding organizations played no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, or approval of the manuscript.
Acknowledgment: This paper is published with the permission of the Director of KEMRI. We gratefully acknowledge the assistance of the medical and nursing staff at Kilifi District Hospital and the Kilifi District Public Health team.