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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.