TABLE 2.

Malaria Epidemiology, Community Health Worker System Structures, and Case Management Policies, 2019, Honduras and Lao PDR

	Honduras	Lao PDR
No. malaria cases	391	6690
Test positivity rate	0.2%	1.3%
Incidence trends	90% decline since 2015	75% decline since 2015
Malaria cases detected by CHWs	55%	27%
CHWs reporting a malaria case	26%	20%
Study Site Details
Study location	Gracias a Dios department	Champasak and Attapeu provinces
Study site test positivity rate	0.6%	0.8%
National cases from study location(s)	60%	39%
CHW network size (study site/national)	330/2,900	483/1,598
Community Health Worker System Overview
Services provided by cadre	Curative malaria services only without paracetamol (vertical cadre)	Curative malaria services only with paracetamol & oral rehydration salts (vertical cadre) Additional health services to communities, based on request from health center staff or recruitment by other vertical programs (e.g., TB, maternal and child health)
Case detection methods	Passive and active	Passive
Gender composition of network	73% female	81% male
Average CHW age, years	41	31–50
Minimum education level	Primary education	Primary education
CHW: population ratio	1: 250 to 1,000	1: 100 to 1,700 (94% of CHWs under 1:1000)
Date CHW cadre established	1960s Malaria Eradication Campaign	2005
CHW renumeration	US$0	US$19 monthly
Key financial and operational partners supporting CHW system	Global Fund, Global Communities	Global Fund, United Nations Office for Project Services, civil society organizations
Body in charge of network management	Coordinated across integrated Ministry of Health units	National Malaria Control Program
National Case Management Policies for Malaria
	Free malaria testing and treatment in the public sector	Free malaria testing and treatment in the public sector
Testing	Rapid diagnostic test (RDT) and accompanying blood slide for confirmation with microscopy for all patients with fever, chills, headache, or profuse sweating in malaria-endemic areas	RDT for all patients with fever or 2 risk factors (e.g., travel to forest and nausea), in malaria-endemic areas
Treatment	P. vivax and P. falciparum cases: chloroquine for blood-stage infections P. falciparum cases: single dose primaquine P. vivax malaria for radical cure: either 14 or 7 days of primaquine	Artmesinin-based combination therapy for all positive cases treated P. vivax and mixed P. vivax/ P. falciparum cases referred to health center or hospital for G6PD testing and primaquine
Referrals	Pregnancy, breastfeeding mothers, infants under 6 months of age and suspect severe malaria cases	Pregnancy, severe cases, P.vivax or mixed P. vivax/ P.falciparum cases, patients with malaria in the past 28 days

Abbreviations: CHW, community health worker; PDR, People's Democratic Republic; RDT, rapid diagnostic test.