Non-malarial fever among pregnant women in Medani Hospital, Sudan: diagnostic uncertainty and overtreatment with quinine

Objective: To investigate the accuracy of malaria diagnosis among pregnant women admitted in Medani Maternity Hospital, Central Sudan during June October 2009 and to investigate the antimalarials prescribed in this setting. Methods: Socio-demographic characteristics and obstetrics history were gathered using pre-tested questionnaires. The finger prick blood samples were collected from pregnant women who admitted as malaria case after an initial microscopic test done by general microscopists for malaria diagnosis. The antimalarial treatment prescribed by treating doctor was inquired for. Results: Only 21(8.6%) out of 243 pregnant women admitted as malaria case after an initial microscopic test done by general microscopists for malaria were found to have blood film positive. There was no significant difference in the specificity of the microscopy accuracy between those who have been investigated in the private and governmental sector, 15/193 (8.2%) vs. 6/60(10%), (P>0.05). Quinine infusion was the prescribed drug in this setting. Conclusions: There is a very poor specificity of malaria microscopy in pregnant women admitted to Madani Maternity Hospital. Quinine was the drug received. Malaria control programme should interfere urgently to change this situation.