1175. Low Treatment Rates and Associated Factors Among Pregnant Women with Syphilis in Zambia

Abstract Background Syphilis in pregnancy is common Africa with prevalence as high 10%. In areas ( > 5%), WHO recommends universal syphilis screening and benzathine penicillin G treatment at the first antenatal clinic (ANC) visit. Implementation barriers include global stock outs supply chain issues. Our goal was to document rates factors associated lack of among pregnant women Zambia. Methods The retrospective cohort study analyzed medical record data from who sought care 10 public ANC clinics Lusaka, Zambia during 2018-2019 tested positive for syphilis. diagnosed based on RPR testing defined documented therapy same facility. Patient characteristics were compared across status using Wilcoxon Rank Sum Test continuous variables, Pearson Chi-Square categorical variables. Simple logistic models binary outcome conducted evaluate potential pregnancy. A multivariable model performed a 2-sided P < 0.05 accepted statistically significant. Results Among 28,480 screened syphilis, 5.6% (n=1363) positive. those median age 27 years, 21% nulliparous 43% living HIV. Most (72%) had their initial visit 2nd trimester 96% rate 42% only factor entry 2019 2018 (aOR 2.2; 95% CI 1.7-2.8; p 0.001). (refer Tables 1-2). Conclusion 5.6%. Recommended cases. No maternal or characteristic therapy. Calendar year may have been unclear reasons. Novel approaches ensure access diagnosis early are needed improve neonatal outcomes. Disclosures All Authors: reported disclosures.