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The annual incidence of Haemophilus influenzae (Hi) meningitis varies around the world; the United States has the highest rate, 45-67 per 100,000, among children under five years old. High rates affect Alaskan natives, Navajo Indians, household contacts and children in day-care centers. In the United States, blacks are at greater risk than whites. Incidence data for countries other than Europe have not been established. In Africa, information on the distribution of the disease is overshadowed by the cerebrospinal meningitis caused by Neisseria meningitides. West African information is limited to that obtained from a single study from Senegal, where the rate was approximately 132 cases per 100,000 in children under one year old. Data were collected from 1985 to 1987 on meningitis cases reported from regional hospitals. The population, in mid-1986, of children under five was 64,311 and under one year old, 10,784. All reported cases were verified, and the index cases and household contacts were followed closely for four weeks. The last visit was made at six months. The controls were selected from a group of healthy children who participated in another study. During this interval, 77 cases of meningitis were reported in children under 5 years old, an incidence of 60 per 100,000 children. Of this group, 64 were less than one year old for a rate of 297 per 100,000 children. The incidence in the less-than-five group parallels the general USA data. The figures for the less-than-one-year group more closely resemble the high-incidence American groups, Alaskan natives and Navajo Indians. The incidence statistics may indeed be low, since facilities for clinical confirmation were not always available. Since the proportions of children under one in developing countries are substantially higher, the number of cases of meningitis is also greater. The case fatality rate (CFR) in The Gambia is 5 to 10 times that of the United States. This disease is a substantial health concern in West Africa, which has unfortunately been overshadowed by malaria and other tropical diseases. The age distribution of cases will enter into decisions to introduce H.Influenza, type B (HIB) vaccine into this area. To provide any benefits, the vaccine must be administered at an early age. (Consumer Summary produced by Reliance Medical Information, Inc.)