Chagas Disease Testing Practices Across Joint Base San Antonio

INTRODUCTION: The impact of Chagas disease in the United States military is unknown. While previous studies have suggested a low number of cases, current testing practices are uncharacterized. This study evaluates the current testing practices for Chagas disease at a large military base in South Texas.

MATERIALS AND METHODS: The electronic health record was queried to identify tests for Chagas disease performed at Joint Base San Antonio between January 2022 and August 2024. For those patients tested, charts were reviewed to document patient factors as well as clinical factors associated with testing.

RESULTS: During the study period, 75 patients were tested for Chagas disease, with 9 (12%) performed on active-duty military personnel. Most patients tested were male (75%) and received care in the outpatient setting (72%). Testing was primarily done due to concern for Chagas cardiomyopathy (45%) or as a screening test before bone marrow transplantation (38%). Risk factors were only documented for 27 (36%) patients with a test and varied by the specialty ordering the test. Four (5%) patients had an initial positive test, but only one (25%), who was tested before bone marrow transplantation, had confirmed infection.

CONCLUSIONS: This study demonstrates that current testing practices at Joint Base San Antonio do not target patients with a high pretest probability of Chagas disease. Efforts should be made to prioritize testing in those at increased risk in the Military Health System to determine the true burden of this infection.