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The aims of the study were to explore hyperactivity-inattention (HI) symptoms and co-existing symptoms of emotional and behavioural problems among African school children and their relationship with health status, socio-demographic factors, and school performance.A case-control approach was used. The Strengths and Difficulties Questionnaire (SDQ) was used to explore the co-existing emotional and behavioural symptoms and a semi-structured interview with parents to explore the socio-demographic variables. The sample included 357 school children at the age of 7-9 years: 183 children were defined as cases, defined by abnormal scores on the SDQ-HI scale and 174 randomly selected children among those with normal scores on the SDQ-HI were defined as controls. No age and gender differences were noticed between the two groups.A younger maternal age at childbirth, and poor school performances were more frequent among cases than controls. Three quarter of the hyperactive-inattentive children had co-existing symptoms according to SDQ, the most common being conduct problems.As in other cultures, co-existence of HI symptoms and emotional and behavioural problems was found in this African setting. Further validation of behavioural screening instruments in African children is called for.