TABLE 2.

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

HondurasLao PDR
No. malaria cases3916690
Test positivity rate0.2%1.3%
Incidence trends90% decline since 201575% decline since 2015
Malaria cases detected by CHWs55%27%
CHWs reporting a malaria case26%20%
Study Site Details
Study locationGracias a Dios departmentChampasak and Attapeu provinces
Study site test positivity rate0.6%0.8%
National cases from study location(s)60%39%
CHW network size (study site/national)330/2,900483/1,598
Community Health Worker System Overview
Services provided by cadreCurative 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 methodsPassive and activePassive
Gender composition of network73% female81% male
Average CHW age, years4131–50
Minimum education levelPrimary educationPrimary education
CHW: population ratio1: 250 to 1,0001: 100 to 1,700 (94% of CHWs under 1:1000)
Date CHW cadre established1960s Malaria Eradication Campaign2005
CHW renumerationUS$0US$19 monthly
Key financial and operational partners supporting CHW systemGlobal Fund, Global CommunitiesGlobal Fund, United Nations Office for Project Services, civil society organizations
Body in charge of network managementCoordinated across integrated Ministry of Health unitsNational Malaria Control Program
National Case Management Policies for Malaria
Free malaria testing and treatment in the public sectorFree malaria testing and treatment in the public sector
TestingRapid diagnostic test (RDT) and accompanying blood slide for confirmation with microscopy for all patients with fever, chills, headache, or profuse sweating in malaria-endemic areasRDT 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

ReferralsPregnancy, breastfeeding mothers, infants under 6 months of age and suspect severe malaria casesPregnancy, 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.