{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:06:41Z","timestamp":1789664801182,"version":"4.0.1"},"reference-count":17,"publisher":"American Society of Tropical Medicine and Hygiene","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,17]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Rabies is a fatal but preventable zoonotic disease that causes more than 20,000 deaths annually in India. Post-exposure prophylaxis (PEP) involves rabies vaccination and passive immunization with rabies immunoglobulin (RIG). Traditional RIG dosing is based on patient weight, whereas wound-only administration targets local viral neutralization at the exposure site. In the present study, antibody responses were compared after a three-dose anti-rabies vaccination in patients receiving either wound-only or weight-based RIG infiltration as part of PEP to assess the noninferiority of the wound-only approach. Patients with category III rabies exposure were enrolled in this noninferiority clinical trial, all of whom received a standard three-dose rabies vaccination. Rabies immunoglobulin was administered either according to body weight or infiltrated only around the wound. Serum rabies-neutralizing antibody titers were measured at predefined intervals. The primary outcome was the proportion of patients exhibiting protective antibody titers; secondary outcomes included RIG usage volume, adverse events, and feasibility in resource-limited settings. Both groups achieved adequate seroconversion with protective antibody titers. Wound-only RIG infiltration produced protective antibody responses comparable to weight-based RIG dosing while substantially reducing RIG volume used and could improve feasibility. Larger studies, including formal cost-effectiveness analyses, are needed to confirm the clinical and programmatic implications.<\/jats:p>","DOI":"10.4269\/ajtmh.26-0343","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:23:18Z","timestamp":1789662198000},"source":"Crossref","is-referenced-by-count":0,"title":["Wound-Only versus Weight-Based Rabies Immunoglobulin in Post-Exposure Prophylaxis: A Quasi-Randomized Asessor Blind Non-Inferiority Trial"],"prefix":"10.4269","author":[{"given":"Aman Dev","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Community Medicine Including Public Health, Government Medical College, Patiala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simmi","family":"Oberoi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Including Public Health, Government Medical College, Patiala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satparna","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Including Public Health, Government Medical College, Patiala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanwardeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Virology, Government Medical College, Amritsar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shailpreet","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Department of Virology, Government Medical College, Amritsar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maninder","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Virology, Government Medical College, Amritsar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Rajput","sequence":"additional","affiliation":[{"name":"Department of Virology, Government Medical College, Amritsar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavya","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Including Public Health, Government Medical College, Patiala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samridh","family":"Singla","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Including Public Health, Government Medical College, Patiala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shefali","family":"Gajebasia","sequence":"additional","affiliation":[{"name":"Department of Community Medicine Including Public Health, Government Medical College, Patiala, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"10","key":"b1","series-title":"Int J Comm Med Pub Health","first-page":"3952","article-title":"India\u2019s sustaining challenges to combat rabies elimination: A comprehensive review","volume":"10","author":"Krishna","year":"2023"},{"issue":"3","key":"b2","series-title":"Hum Vaccin Immunother","first-page":"837","article-title":"Local infiltration of rabies immunoglobulins without systemic intramuscular administration: An alternative cost effective approach for passive immunization against rabies","volume":"12","author":"Bharti","year":"2016"},{"key":"b3","series-title":"Vaccine","first-page":"A166","article-title":"Modelling to inform prophylaxis regimens to prevent human rabies","volume":"37 Suppl 1","author":"Hampson","year":"2019"},{"issue":"5","key":"b4","series-title":"Hum Vaccin Immunother","first-page":"2081024","article-title":"Safety and clinical efficacy of human rabies 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rabies to study the humoral and cellular immune response to a T-cell dependent neoantigen in man","volume":"23","author":"Brinkman","year":"2003"},{"issue":"3","key":"b16","series-title":"Clin Infect Dis","first-page":"387","article-title":"Comparison of a novel human rabies monoclonal antibody to human rabies immunoglobulin for postexposure prophylaxis: A phase 2\/3, randomized, single-blind, noninferiority, controlled study","volume":"66","author":"Gogtay","year":"2018"},{"issue":"2","key":"b17","series-title":"Semin Immunopathol","first-page":"239","article-title":"Sex differences in vaccine-induced humoral immunity","volume":"41","author":"Fischinger","year":"2019"}],"container-title":["The American Journal of Tropical Medicine and 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