<p>A total of 7,285 suspected cases were reported. 47% &lt; one year of age, 58% were males, 42% and 17% of cases were reported from Taiz and Ibb governorates, respectively. The overall case fatality rate was 3.6% and varied by year from the lowest of 1.9% in 2021 to the highest 4.8% in 2019. The most common presentations were: fever (99%), seizure (74%), and vomiting (39%). 81% received antibiotics prior to a week of admission, 69% and 70% were vaccinated for Streptococcus pneumoniae and Haemophilus influenza type b (Hib) respectively. Cerebral spinal fluid (CSF) of 93% (6743) cases examined. Microbial culture, rapid Latex, and Bainx tests were performed for 99.8 % (6732), 7% (454), and 28% (1893) of samples and the positivity rates were 0.4%, 4% and 4%, respectively. S.pneumoniae was the commonly isolated organism by ( 0.2% and 6.4 %) by microbial culture and repaid tests, reservedly.</p>