Sema Mandal

Sema Mandal
Public Health England | HPA · Immunisation, Hepatitis, and Blood Safety department

MBBS DTM&H MRCP MSc FFPH

About

114
Publications
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2,678
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Introduction
Sema Mandal currently works at the Immunisation, Hepatitis, and Blood Safety department, Public Health England. Sema does research in Public Health, Immunisation, Hepatitis, Infectious Diseases and Epidemiology. She is a co-applicant and co-investigator on hepatitis research grants. Their most recent publication is '‘Just another vial…’: a qualitative study to explore the acceptability and feasibility of routine blood-borne virus testing in an emergency department setting in the UK'.

Publications

Publications (114)
Article
Background: Blood-borne viruses (BBVs) cause significant morbidity and mortality worldwide. Emergency departments (EDs) offer a point of contact for groups at increased risk of BBVs who may be less likely to engage with primary care. We reviewed the literature to evaluate whether BBV testing in this setting might be a viable option to increase cas...
Preprint
Full-text available
We compare two multi-state modelling frameworks that can be used to represent dates of events following hospital admission for people infected during an epidemic. The methods are applied to data from people admitted to hospital with COVID-19, to estimate the probability of admission to ICU, the probability of death in hospital for patients before a...
Preprint
Full-text available
The introduction of vaccination has changed the landscape for COVID-19 infection, vastly altering the presentation of symptoms and reducing morbidity of infection. We estimate monthly trends and the impact of vaccination upon hospitalised mortality, controlling for baseline demographics and hospital load. We apply competing risks methods to compreh...
Article
Background Surveillance programmes undertaken in infants born to hepatitis B virus (HBV) infected mothers provide an opportunity to analyse virological markers from the neonate and early infancy. These data inform on mechanisms of HBV transmission and how available interventions can be better utilised for control of HBV infections arising at the mo...
Article
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Direct‐acting antiviral (DAA) therapy for anybody with viraemic HCV infection has been scaled‐up in England since 2017. To assess early impacts, we investigated trends in, and factors associated with, HCV viraemia among people who inject drugs (PWID). We also examined trends in self‐reported treatment access. Bio‐behavioural data from an annual, na...
Article
Full-text available
Objectives Although hepatitis B virus (HBV) vaccination for high-risk groups including gay, bisexual and other men who have sex with men (MSM) is recommended in the UK, data on HBV immunisation coverage are limited. This study aimed to understand the prevalence of HBV infection, susceptibility and immunity due to immunisation among a high-risk popu...
Article
Full-text available
Background A multi-tiered surveillance system based on influenza surveillance was adopted in the United Kingdom in the early stages of the coronavirus disease (COVID-19) epidemic to monitor different stages of the disease. Mandatory social and physical distancing measures (SPDM) were introduced on 23 March 2020 to attempt to limit transmission. A...
Preprint
Full-text available
Objectives: Robust outcome information for patients hospitalised for COVID-19 in England is lacking. We estimate monthly trends, accounting for baseline characteristics, for a cohort of hospitalised patients during 2020. Design: Retrospective cohort study using parametric multi-state mixture models. Setting: Hospital and ICU admissions at 31 Nation...
Article
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Background UK migrants born in intermediate to high prevalence areas for blood borne viruses (BBV) including hepatitis B, hepatitis C and HIV are at increased risk of these infections. National guidance from Public Health England (PHE) and National Institute for Health and Care Excellence (NICE) recommends primary care test this population to incre...
Article
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Background People who inject drugs are at increased health risk in a pandemic due to their greater susceptibility to severe disease and as a consequence of the restrictions put in place to halt the spread of infection. Harm reduction (HR) services, which aim to reduce the negative effects of drug use on health, are likely to be diminished in a pand...
Preprint
Full-text available
Background People who inject drugs (PWID) are at increased health risk in a pandemic due to their greater susceptibility to severe disease and as a consequence of the restrictions put in place to halt the spread of infection. Harm reduction (HR) services, which aim to reduce the negative effects of drug use on health, are likely to be diminished in...
Article
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Around 200,000 people live with chronic hepatitis B in England. Despite national guidance on identification and management of cases and their close contacts, testing rates of close contacts is as low as 43% in high prevalence areas of London. Our study aimed to determine whether a nurse-led enhanced management and contact tracing of chronically inf...
Article
Full-text available
Introduction Liver transplantation is an important measure of burden from hepatitis C virus (HCV)-associated liver disease. Aims To describe transplant rates and survival in individuals with HCV infection from 2008 to 2017 in England through data linkage. Methods This is a retrospective observational cohort study. Laboratory reports of HCV infect...
Article
Background: Neisseria meningitidis is a rare cause of acute bacterial conjunctivitis but can progress to invasive meningococcal disease (IMD) in the case and their close contacts. There is, however, a lack of consensus on the clinical and public health management of primary meningococcal conjunctivitis (PMC). Methods: We searched Ovid MEDLINE vi...
Article
Persons with chronic hepatitis C (HCV) infection are at increased risk of end‐stage liver disease (ESLD) and hepatocellular carcinoma (HCC). The impact of hepatitis treatment scale‐up and elimination strategies on ESLD and HCC incidence is a critical measure of progress towards WHO targets. Data from national laboratory surveillance of HCV diagnose...
Article
Full-text available
Introduction Hepatitis C virus (HCV) is the second largest contributor to liver disease in the UK, with injecting drug use as the main risk factor among the estimated 200 000 people currently infected. Despite effective prevention interventions, chronic HCV prevalence remains around 40% among people who inject drugs (PWID). New direct-acting antivi...
Article
Full-text available
Background and objectives: Birth cohort screening for the hepatitis C virus (HCV) has been implemented in the US, but there is little evidence of its cost-effectiveness in England. We aim to evaluate the cost-effectiveness of one-time HCV screening for individuals born between 1950 and 1979 as part of the National Health Service health check in En...
Article
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Background Monitoring trends in mortality for individuals diagnosed with hepatitis C virus (HCV) infection are important as we expand treatment and move towards World Health Organization elimination targets.AimTo estimate mortality rates for individuals aged ≥ 15 years diagnosed with HCV infection in England 2008-16.Methods An observational cohort...
Article
Full-text available
Most migrants who come to the UK are young and healthy adults, but some have specific health needs that may be less familiar to health practitioners. This article describes migration patterns and highlights key points for migrant-sensitive care in general practice The UK has a long history of migration and in 2018 an estimated 14% of the population...
Article
Through record linkage, we describe the causes of death among persons with diagnosis of hepatitis C virus (HCV) in England. Persons ≥1 year with anti‐HCV/HCV‐PCR tests reported to PHE sentinel surveillance during 2002‐2016 were linked to death registrations from the Office for National Statistics during 2008‐2016. We found that 8.6% of the 204 265...
Article
Introduction: Hepatitis C (HCV) infection in England primarily affects people who inject drugs (PWID). We describe persons HCV tested, estimate incidence and establish the cascade of care (CoC) for people engaging with drug services. Methods: Persons testing for HCV in drug services in Sentinel Surveillance of Blood Borne Virus Testing (SSBBV) b...
Article
Full-text available
Objectives Increased test uptake for HIV and viral hepatitis is fast becoming a health priority at both national and global levels. Late diagnosis of these infections remains a critical public health concern in the UK. Recommendations have been issued to expand blood-borne virus (BBV) testing in alternative settings. Emergency departments (EDs) off...
Article
Full-text available
In this paper we build on work investigating the feasibility of human immunodeficiency virus (HIV) testing in emergency departments (EDs), estimating the prevalence of hepatitis B, C and HIV infections among persons attending two inner-London EDs, identifying factors associated with testing positive in an ED. We also undertook molecular characteris...
Article
Through record linkage we describe causes of death among persons with diagnosis of HCV in England. Persons ≥1yrs with anti‐HCV/HCV‐PCR tests reported to PHE sentinel surveillance during 2002‐2016 were linked to death registrations from the Office for National Statistics during 2008‐2016. We fouind that 8.6% of the 204,265 with evidence of HCV durin...
Article
In August 2015 two community outbreaks of hepatitis A virus (HAV) occurred in sub-urban communities in Northern England. Each was managed by an independent outbreak control team. In outbreak one, mass vaccination was deployed targeting a residential area and two schools, while in outbreak two, vaccination was reserved for household-type contacts of...
Article
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Background: We report on an outbreak of hepatitis A among men who have sex with men (MSM) in England and its associated healthcare resource burden, the strategies used to control the outbreak and the role of past and current hepatitis A vaccination policy and practice in England. Methods: National surveillance of hepatitis A, including reference...
Article
Objectives: The aim of the study was to estimate HIV prevalence among persons with hepatitis B virus (HBV) infection in England and to examine associated risk factors. Methods: Persons aged≥15 years with an HBV surface antigen (HBsAg) test reported to Public Health England (PHE) sentinel surveillance during 2008–2014 were linked to the PHE nationa...
Article
Full-text available
In England, 160,000 individuals were estimated to be chronically infected with hepatitis C virus (HCV) in 2005 and the burden of severe HCV‐related liver disease has increased steadily for the past 15 years. Direct‐acting antiviral treatments can clear infection in most patients, motivating HCV elimination targets. However, the current burden of HC...
Article
Full-text available
The public health response to sporadic hepatitis A virus (HAV) infection, hepatitis A, can be complex especially when the index case is a child and no obvious source is identified. Identifying an infection source may avoid mass immunisation within schools when transmission is found to have occurred within the household. Screening of asymptomatic co...
Article
Full-text available
Background Monitoring hepatitis C virus (HCV) incidence is important for assessing intervention impact. Longitudinal studies of people who inject drugs (PWID), using repeated biological tests, are costly; alternatively, incidence can be estimated using biological markers of recent infection in cross-sectional studies.AimWe aimed to compare incidenc...
Article
Full-text available
Objectives: A routine review of hepatitis A travel vaccination recommendations was brought forward in June 2017 due to hepatitis A vaccine shortages and a concurrent outbreak in men who have sex with men (MSM). There were three objectives: first, to document the review process for changing the recommendations for the UK travellers in June 2017. Sec...
Article
In May 2016, the World Health Assembly ratified the first ever Global Health Sector Strategy (GHSS) on Viral Hepatitis to eliminate viral hepatitis as a public health threat by 2030. In pursuit of this elimination goal and recognising that hepatitis control through immunisation is an essential foundation of a hepatitis B prevention programme, the W...
Article
Full-text available
Background: The UK, like a number of other countries, has a refugee resettlement programme. External factors, such as higher prevalence of infectious diseases in the country of origin and circumstances of travel, are likely to increase the infectious disease risk of refugees, but published data is scarce. The International Organization for Migrati...
Article
Objectives In persons with hepatitis C virus (HCV) infection, HIV coinfection leads to faster progression to advanced liver disease. The aim of our study was to estimate diagnosed HIV prevalence among people with evidence of current HCV infection (polymerase chain reaction positive) and examine predictors of coinfection. Methods Adults (≥ 15 years...
Article
Full-text available
Background Hepatitis C (HCV) diagnosis and care is a major challenge for people who use illicit drugs, and is characterised by low rates of testing and treatment engagement globally. New approaches to fostering engagement are needed. We explored the acceptability of remote forms of HCV testing including self-testing and self-sampling among people w...
Conference Paper
Introduction Between April 2012 and May 2015, a cluster of acute Hepatitis B virus (HBV) infection was investigated by Public Health England (PHE) in Southwest England. Compared nationally, it was observed that cases were above the average age, all male and did not belong to typical ‘high-risk’ groups; with a majority reporting no risk-factors for...
Article
Full-text available
Background: It is believed that between 2 and 5% of infants born to HBV-infected mothers at a high risk of perinatal transmission will become persistently infected in spite of immunisation starting at birth. We investigated factors associated with breakthrough infections. Methods: Sixty nine samples from HBV-infected infants born between 2003 an...
Article
The United Kingdom has committed to eliminating viral hepatitis as a public health threat. Innovative interventions for marginalized populations are required to realize this goal. In 2016, the HepCATT study team implemented a complex hepatitis C (HCV) intervention in three English drug treatment services, with five controls. We report qualitative s...
Article
Little is known about engagement and retention in care of people diagnosed with chronic hepatitis C (HCV) in England. Establishing a cascade of care informs targeted interventions for improving case-finding, referral, treatment uptake and retention in care. Using data from the Sentinel Surveillance of Blood Borne Virus testing (SSBBV) between 2005-...
Article
Purpose: In August 2015, in response to increasing group W invasive meningococcal disease (IMD) nationally, a MenACWY vaccine programme was introduced in the UK for 13-18year olds. We reviewed the epidemiology of IMD in young adults and university-associated cases in England during 2014-15 academic year and assessed the potential impact of differe...
Conference Paper
Full-text available
Introduction Hepatitis A virus (HAV) is a vaccine-preventable infection, mainly travel-associated in the UK. Since July 2016 Public Health England has detected an increase in hepatitis A laboratory notifications in men who have sex with men (MSM). We described the outbreak characteristics to inform implementation of nation-wide control measures. Me...
Article
Full-text available
Background Despite the introduction of universal hepatitis B immunization programs worldwide, outbreaks of acute infection still occur in unimmunized individuals. A timely diagnosis of hepatitis B is necessary to ensure adequate clinical care and public health interventions that will reduce transmission. Yet, interpretation of hepatitis B serologic...
Article
Full-text available
Between July 2016 and January 2017, 37 confirmed cases of hepatitis A with two unique IA genotype strains primarily among men who have sex with men, were reported across eight areas in England and Northern Ireland. Epidemiological and laboratory investigations indicate that these strains may have been imported several times from Spain, with seconda...
Technical Report
Full-text available
Since February 2016, 24 hepatitis A cases infected with two distinct strains of sub-genotype IA have been reported by five EU countries. Most cases are reported among adult men who have sex with men (MSM), with only a few women affected, including one suspected person who injects drugs (PWID). Eight cases reported having travelled to Spain within t...
Article
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Background: rVSV-ZEBOV is a recombinant, replication competent vesicular stomatitis virus-based candidate vaccine expressing a surface glycoprotein of Zaire Ebolavirus. We tested the effect of rVSV-ZEBOV in preventing Ebola virus disease in contacts and contacts of contacts of recently confirmed cases in Guinea, west Africa. Methods: We did an o...
Article
The cover image, by Helen E Harris et al., is based on the Original Article New treatments for hepatitis C virus (HCV): scope for preventing liver disease and HCV transmission in England, DOI: 10.1111/jvh.12529.
Article
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In 2009 in the Active Bacterial Core surveillance (ABCs) sites, penicillin was not commonly used to treat meningococcal disease. This is likely because of inconsistent availability of antimicrobial susceptibility testing (AST) and ease of use of third-generation cephalosporins. Consideration of current practices may inform future meningococcal dise...
Poster
We estimate HIV prevalence among those testing for HCV and with evidence of active HCV infection, and examine associated risk factors.
Article
Full-text available
This report describes a joint measles outbreak investigation between public health officials in the United Kingdom (UK) and the Netherlands following detection of a measles cluster with a unique measles virus strain. From 1 February to 30 April 2014, 33 measles cases with a unique measles virus strain of genotype B3 were detected in the UK and the...