Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia

Abstract

Background Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community’s knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia. Methods A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Communities aged 6 years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics. Results Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bednet ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% aware of bednets were use to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their house and 20.1% reported entering nearby forests within the last six months. Conclusion We conclude that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices with respect to managing malaria require marked improvement.

Sero-prevalence of malaria and the knowledge, attitudes and practices relating to the prevention of malaria among indigenous people living in the central forest spine in Peninsular Malaysia: a mixed-methods study

“…Due to the extensive spotlight on malaria among these communities by the national malaria elimination programme, the results of this study showed adequate knowledge, attitude and practice in the prevention and control of malaria, which is consistent with other studies [26][27][28][29][30]. Similar to the findings of this study, the study by Munajat et al conducted among Indigenous population in Kelantan showed almost half of the participants had adequate knowledge on the causes and symptoms of malaria [15]. Similarly, the results were comparable with other international studies which show good knowledge, attitude and practice towards the prevention of malaria [26,27,[31][32][33].…”

“…Better knowledge, attitudes and practices related to malaria may help the community against malaria, provided they are given access to resources and services that enable them to put into action. A study among an Orang Asli community in eastern Peninsular Malaysia suggested more health promotion activities to empower and enhance better attitudes and practices associated to managing malaria infections were needed [15]. Malaysia is a tropical country with hot and humid climate, and is currently undergoing rapid changes in the environmental landscapes including intensive use of land for agriculture and urbanisation, which may lead to efficient breeding grounds for mosquitoes to thrive.…”

Seroepidemiological surveillance, community perceptions and associated risk factors of malaria exposure among forest-goers in Northeastern Thailand

“…In a retrospective study, the border regions of Thailand-Myanmar and Thailand-Cambodia, with high numbers of migrant workers, were found to have the highest malaria incidence rates, including Plasmodium falciparum, Plasmodium vivax, and mixed infection (Imwong et al, 2015). Several studies also documented naturally acquired human infections with non-human primate malaria in areas near the border with Malaysia (Putaporntip et al, 2009;Jongwutiwes et al, 2011;Ngernna et al, 2019), thus serving as warning signs of an increasing zoonotic malaria burden in Thailand.…”

“…These populations also live and work in areas with high malaria transmission and high human-vector contacts, such as forests and forest-fringe areas. They are mostly illiterate, deprived, and poorly connected with public health and surveillance programs, hospitals, and legitimate pharmacists (Parker et al, 2015;Munajat et al, 2021). They are more likely to seek treatment from unregulated, private vendors who may raise their risk of exposure to non-standard and counterfeit medications or artemisinin-based monotherapies (Yeung et al, 2008).…”

Evaluation of Knowledge, Attitudes and Practices of Malaria Among Forest-Goer Communities in Mukdahan Province, Northeastern Thailand

“…These populations also live and work in areas with high malaria transmission and high human-vector contacts, such as forests and forest-fringe areas. These populations are mostly illiterate, deprived, and poorly connected with public health and surveillance programs, hospitals and legit pharmacists [5,13]. They are more likely to seek treatment from unregulated, private vendors who may raise their risk of exposure to non-standard and counterfeit medications or artemisinin-based monotherapies [14].…”