{
  "abstract": "Background: Rabies is an almost invariably fatal, vaccine-preventable zoonosis. Rabies immunoglobulin (RIG) is recommended for Category III exposures, yet real-world RIG utilization remains poorly characterized. This study examined temporal trends and factors associated with RIG utilization and delayed presentation among Category III exposure patients in China.\n\nMethods: A retrospective study was conducted using clinical records of Category III exposure patients presenting to a high-volume rabies prevention clinic in Hangzhou, China, from 2015 to 2024. Calendar year 2018 was treated as a temporal reference year for descriptive comparison. Multivariable logistic regression identified factors associated with RIG non-administration and delayed presentation (>24 h post-exposure).\n\nResults: A total of 14,270 eligible cases were analyzed. Overall RIG utilization was 37.54%, declining from 53.09% in 2015 to 7.14% in 2022. RIG non-administration was independently associated with male sex (OR 1.20, 95% CI 1.11–1.29), age 18–59 years (OR 3.25, 95% CI 2.95–3.59), exposure at home (OR 1.47, 95% CI 1.33–1.63), presentation in 2018 (OR 2.38, 95% CI 2.01–2.82) and in 2019–2024 (OR 4.49, 95% CI 3.96–5.09), and delayed presentation (OR 1.43, 95% CI 1.32–1.55). The overall delayed presentation rate was 34.47%; independent risk factors included age 18–59 years (OR 1.37, 95% CI 1.24–1.52), exposure at home (OR 1.57, 95% CI 1.41–1.74), and presentation in 2018 (OR 1.61, 95% CI 1.40–1.86) and in 2019–2024 (OR 1.77, 95% CI 1.62–1.94).\n\nConclusion: RIG utilization was low and showed marked temporal variation during 2015–2024, and one third of patients presented more than 24 h after exposure. Both outcomes were concentrated among working-age adults and domestic exposure settings. These findings describe service utilization patterns and identify subgroups in which gaps in PEP delivery are concentrated; targeted risk communication and routine monitoring of RIG utilization and presentation timeliness are needed.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Infectious Disease Control and Prevention, Hangzhou Center for Disease Control and Prevention (Hangzhou Health Supervision Institution) , ,",
    "Department of Epidemiology and Biostatistics, School of Public Health and The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine , ,",
    "Department of General Medicine, Hangzhou Occupational Disease Prevention and Treatment Hospital , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jing Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Weiwei Cai"
    },
    {
      "affs": [
        1
      ],
      "name": "Jiaxin Chen"
    },
    {
      "affs": [
        2
      ],
      "name": "Jing Chen"
    },
    {
      "affs": [
        2
      ],
      "name": "Wanli Yang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e4ka7x1z0dhs7.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1916685",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690772/?tool=EBI",
  "id": "e4ka7x1z0dhs7",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13690772",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2406|Rabies epidemiology and control"
    ]
  ],
  "openalex": "W7221080578",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13690772/pdf/?tool=EBI",
  "pmcid": "PMC13690772",
  "pmid": null,
  "published": "2026-10-09",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/e4ka7x1z0dhs7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:59Z",
      "native_id": "PMC:PMC13690772",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13690772"
    },
    {
      "first_seen": "2026-10-30T12:20:22Z",
      "native_id": "10.3389/fpubh.2026.1916685",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1916685/full"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "openalex:2406|Rabies epidemiology and control",
      "subfield": "microbiology"
    }
  ],
  "title": "Rabies immunoglobulin utilization and delayed presentation following category III rabies exposure: a 10-year retrospective study in Hangzhou, China",
  "title_text": "Rabies immunoglobulin utilization and delayed presentation following category III rabies exposure: a 10-year retrospective study in Hangzhou, China",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:22Z",
  "url": "https://research.draconitic.com/paper/e4ka7x1z0dhs7",
  "venue": "Frontiers in public health",
  "versions": []
}