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To compare the prevalence of Streptococcus pneumoniae by rapid urinary test and blood culture in children with respiratory tract infection and healthy children (controls). Pneumococcal antigenuria was detected in 31.5 % of CAP, 31.5 % of rhinosinusitis cases and 6 % of controls. Pneumococcal antigenuria was significantly more frequently detected in both CAP and rhinosinusitis cases than controls (Fishers exact test; CI 95%, p = 0.01). In no cases of non pneumococcal CAP was antigenuria detected. Compared with blood culture, the specificity of the Pneumococcal antigenuria test was 94%. Nasopharyngeal carrier states for S.pneumoniae in healthy control are very low (6%). We recommend the rapid urinary antigen test to conventional cultural methods for early diagnosis of pneumococcal respiratory infection as a basis for starting appropriate treatment.This study help to inform policy making for the mass infant immunization with PCV7 in our country to decrease incidence of invasive pneumococcal disease. [PUBLICATION ABSTRACT]