I'm surprised that no one has responded yet Paul, but perhaps, like myself, they don't know what to say. It certainly looks like a keris hilt form and i agree that Sumatra is most likely, but frankly it doesn't seem to fall neatly into any style i have seen before. The rather large pesi hole is also a bit unusual, but i would still think it's intention was to be a hilt.
Frankly, while it does appear to have some age it does not seem to be too old. It has some yellowing and patina, but the carved lines are not particularly worn. Color and patina can be added to ivory easier than some other materials. I suspect this might be from the latter half of the 20th century.
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