Profile of HRIG Utilization among Category III Animal Bite Patients Attending an Anti-Rabies Clinic: A Cross-Sectional Study

Abstract

Background: Rabies remains a major public health challenge in India despite the availability of effective post-exposure prophylaxis (PEP). Human Rabies Immunoglobulin (HRIG) plays a crucial role in the management of WHO Category III animal bite exposures by providing immediate passive immunity. However, HRIG utilization remains inadequate in many tertiary care Anti-Rabies Clinics because of delayed presentation, limited availability, and operational challenges.

Objective: To assess the utilization profile of HRIG among WHO Category III animal bite patients attending a tertiary care Anti-Rabies Clinic and to identify factors associated with its non-utilization.

Methods: A hospital-based descriptive cross-sectional study was conducted at the Anti-Rabies Clinic of a tertiary care teaching hospital from July 2025 to December 2025. Out of 2316 patients attending the ARV OPD during the study period, 1829 patients with WHO Category III animal bite exposure were included using universal sampling technique. Data regarding sociodemographic characteristics, bite profile, HRIG utilization pattern, and reasons for non-utilization were collected using a predesigned semi-structured questionnaire and treatment records. Data were analyzed using Jamovi software and expressed as frequencies and percentages.

Results: Among the 1829 Category III animal bite patients, HRIG was administered to 631 (34.5%) patients. Majority of the patients were males (64.5%) and from rural areas (69.1%). Dog bites constituted 89.5% of exposures, while lower limb bites were the most common site of injury (60.3%). HRIG utilization was higher among children below five years, head and neck bite victims, patients with multiple deep wounds, and individuals with comorbidities. Delayed presentation after initiation of ARV beyond the recommended period (36.6%), healed or minor appearing wounds (27.1%), limited HRIG availability (22.1%), and patient refusal (14.2%) were the major reasons for non-utilization. Adverse reactions following HRIG were minimal and predominantly mild local reactions.

 Conclusion: HRIG utilization in the tertiary care Anti-Rabies Clinic was selectively prioritized for high-risk exposures. Delayed healthcare seeking behaviour and limited HRIG availability were major barriers to optimal utilization. Strengthening uninterrupted HRIG supply, increasing public awareness regarding early reporting after animal bites, and implementing standardized institutional protocols may improve adherence to rabies PEP guidelines in tertiary care settings.

DOI: https://doi.org/ 10.24321/0973.5038.202607

How to cite this article:
Sahu P, Behera T R. Profile of HRIG Utilization among Category III Animal Bite Patients Attending an Anti-Rabies Clinic: A Cross-Sectional Study. APCRI J. 2026; 28(1): 15-19.