Perceptions of malaria and preventive practices used among Orang Rimba forest dwellers in Sumatra Indonesia

Abstract

Abstract Background Southeast Asia aims to eliminate malaria by 2030, requiring that risk factors for malaria among hard-to-reach populations be understood and addressed. This is the first study of malaria risks on the Orang Rimba, a culturally unique nomadic ethnic group residing in the lowland rain forests of Sumatra, Indonesia that usually functions outside of the health system. This study characterizes perceptions of malaria and preventive practices used, to inform the selection of interventions that can support malaria elimination efforts for this specific and sensitive population.Methods A small cross-sectional survey was conducted among the Orang Rimba people in the Sarolangun District of Jambi, Indonesia between March and May of 2021. The survey identified participant demographics, their knowledge of malaria, prevention practices in use, and pregnancy-related health behaviors among females. For cultural reasons, questions for women were asked through men.Results We enrolled 39 participants, 87% of which were male. Most participants (77%) had no formal schooling, and all worked in agriculture and/or hunting. Their understanding of malaria was limited, with approximately half understanding that malaria transmission takes place through the bite of an infected mosquito, and 62% citing fever as a symptom of malaria. The vast majority of participants (90%) used mosquito coils and/or insecticide-treated bednets (ITNs) (87%) the night before the survey. Women did not perceive malaria to be a greater health risk in pregnancy, and received limited prenatal care (29%) and ITNs (46%) during their pregnancies.Conclusions Orang Rimba forest dwellers in Sumatra are vulnerable, socioeconomically disadvantaged, and separated from the healthcare system. If Indonesia and the Greater Mekong Subregion are to meet their goal to eliminate malaria by 2030, deliberate and continuous efforts targeted at reducing outdoor transmission among the Orang Rimba communities will be essential. Education on malaria and the provision of prenatal care would likely benefit this community.