742. Evaluation of Chagas Disease Diagnostic Testing Practices in Four Hospital Systems in California and Texas

Abstract Background Chagas disease (CD) is a neglected parasitic that affects >6 million people in the Americas, including >200,000 United States (US). Medical provider knowledge of CD key to decreasing morbidity and transmission; however, few studies have assessed diagnostic practices US health systems serving at-risk patients. Our study aimed describe existing approaches diagnosing California Texas. Methods Site-based research teams at four hospital (the University [UC] San Francisco [UCSF], Diego [UCSD], Irvine [UCI], Harris Health System [HHS] Houston, TX) retrospectively identified patients ≥18 years old tested for between 2016-2019 systematically extracted electronic medical record data using complementary entry forms. Specifically, eligible were laboratory orders UCSF UCI, while remaining sites employed SlicerDicer (Epic Systems). This was approved by institutional review boards each site. Results We 333 CD, 109 from UCSF, 88 UCSD, 25 111 HHS. These had 125, 99, 31, 181 tests sent commercial laboratories, respectively. Test reactivity varied system with greatest percent among ordered UCI (23%) followed UCSD (16%), HHS (15%), (10%). Among who screened positive assays, confirmatory testing through Centers Disease Control Prevention sought 100% UCI; 59% HHS, 55% 40% UCSD. The specialty most often Cardiology all UC (UCSF, 50%; 55%; 35%) Internal Medicine (46%; 13%). Only one recorded test an Obstetrics/Gynecology service any Conclusion early results report positivity rates our healthcare demonstrate inconsistency attaining recommended testing, as well paucity despite risk congenital transmission. findings suggest areas opportunity improve awareness lay foundation standardizing US. Disclosures Caryn Bern, MD, MPH, UpToDate (Wolters Kluwer) (Other Financial or Material Support, Author Royalties)