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IMPALA Question Set


Respiratory disease is a major cause of illness, disability and death. These tools have been designed for use in sub-Saharan Africa, where disease burdens are extremely high. They allow researchers a standardized set of questions to enumerate the symptoms of respiratory disease, and the risk factors for respiratory ill-health.

These questionnaires have not yet been fully field-evaluated, but a description of the process by which they were created can be found at


This question set has been produced using the XLSForm template (an Excel representation of XForms). XForms can be used with Enketo, KoboToolbox, ODK and other packages. The choice of which platform to use is yours.


This collection of questionnaires include:

  • IMPALA_Symptoms - for assessment of respiratory symptoms.
  • IMPALA_Energy - for enumeration of household sources of air pollution, including cookstove use
  • IMPALA_LifeExposures - for assessment of other air pollution at work and in the home
  • IMPALA_Nutrition - Based on the Global Asthma Network nutrition questions, this abbreviated tool gives semi-quantitative assessment of food group intake
  • IMPALA_Smoking - for enumeration of first hand tobacco exposure (second-hand smoke exposure is contained within the LifeExposures question set.
  • IMPALA_TB - for enumeration of previous tuberculosis treatments and their outcomes.

Try out the forms online

You can try the forms within KoboToolbox. Please note that these versions may not be as up to date as those here. Feel free to submit dummy data, but not patient data please.

How-to guide

For setting up questionnaires on your own account using KoboToolbox (

  • Download the XLSForms from this site to your computer
  • Create an account at
  • Click the "NEW" button, and select "Upload"
  • In the file dialog box which opens, find the XLSForm which you saved on your computer, select it, and click "Open"
  • You now have the form uploaded to KoboToolbox, and can edit or preview it in draft
  • When you want to test it for real, click "Deploy"
  • After deployment, under "Collect data" there are options to "Copy" or "Open". If you wish to share the questionnaire entry with others, click the Copy button, which will put the URL into your clipboard. It should look similar to the ones above if you paste it into an email or editor. Click "Open" to just try the form straight away. The same XLSForms can be used to upload the questionnaires to ODK or another data collection software.

Support and error reporting

These question sets are provided in XLSForm format, and the following sources of information may be useful:

For reports of errors, please contact the authors.


This question set has been the result of a large collaborative effort, with many authors, as part of the IMPALA network. The files are provided with no guarantee of support, but we will do our best to respond to your questions.

  • Jamie Rylance - Co-ordinator - jipp3r


We would be delighted if you are able to contribute to these question sets. Firstly by reporting errors, but secondly by translating to new languages. If you have a translated version, please contact us.


This project is made available under Creative Commons CC BY-ND license ( This is to maximize the use of the questions, but maintain coherence of the data collection to allow comparisons across data sets.

  • You are free to share — copy and redistribute the material in any medium or format for any purpose, even commercially.
  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.

We acknowledge the use of the ISCO-88 questionnaire, generated by the International Labour Organization ( This is provided as a reference, and to help users incorporate this classification into their data collection.


Efforts have been made to verify correct operation of this set of questions. However, no liability is accepted arising from their use. The contents are provided "as is", without any express or implied warranty, and no implication of fitness for a particular use. This package is supplied for informational use only. It is not a source of medical information.


Numerous individuals have kindly given their time and expertise in the development of these questionnaire. Thankyou very much! Specifically we wish to acknowledge:


A question set designed for survey use in sub-Saharan Africa for assessment of respiratory disease and risk factors







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