Clinical Service

The pharmacy department is divided into the drug logistics section on one hand and the clinical section (comprising research, treatment and care components) on the other. The latter section has pediatric and adult units that offers patient pharmaceutical care to general patients as well as those on research studies. It also has a private pharmacy that offers care to patients in the private clinic.

The department has a staff of four pharmacists (head of department inclusive) and five pharmacy technicians with nearly 60 years of cumulative post-registration experience among them most of which in HIV/AIDS Research, treatment and care as well as ARV Logistics Management.

The adult outpatient clinic serves clients living with HIV and AIDS providing consultation and counselling services. Up to 200 clients are seen in the adult clinic on a daily basis. In the clinic, clients on antiretroviral therapy are periodically reviewed and in addition to reviewing ART medication, they are managed for incident opportunistic infections or other concomitant conditions. The clients also receive adherence counselling in the clinic as well as any other psychosocial support they may need. The clinic also conducts HIV counselling and testing for adults wishing to check their HIV status. The clinic has a dedicated team of medical officers, nurses, counsellors and phlebotomists. It also has data officers, receptionists and research assistants.

The private clinic offers various services at a fee. It also serves clients who are on various insurance schemes such as AAR, Sanlam, Liberty, ICEA Jubilee etc. The clinic offers a wide range of services including HIV care. However the clinic also serves clients who are on third line antiretroviral medication (the salvage or third line clinic) every Wednesday and clients living with HIV who have renal disease (renal clinic) every Tuesday.

These latter services are  supported by the CDC-IDI HIV project. The private clinic has a dedicated private pharmacy and counselling service. Physicians, medical officers, nursing officers, a senior counsellor, pharmacist and phlebotomist staff the private clinic. The clinic operates from 8am to 5pm on a daily basis.

The pediatric clinic serves children living with HIV and AIDS. Because of aggressive strategies in prevention and treatment in the adult management of HIV, there has been a decline in the children born with the disease. About 60 children are served in the clinic per day. In addition to treatment, other services offered in the clinic include psychosocial support that include disclosure of status, adherence and relationships. There is also nutritional counselling for young mothers and there is a special clinic for monitoring infants born to HIV Positive mothers (EID Clinic) where mothers are advised on breast-feeding and receive other nutritional counselling and infants are periodically tested for HIV up to when they are 2 years. The clinic also offers orphans and vulnerable children (OVC) services focusing referrals and linkages for OVC care. The pediatric clinic is also heavily involved in conducting research on HIV care, sickle cell disease and in cardiology (focusing on rheumatic heart disease).

The radiology department at Joint Clinical Research Centre became operational in January 2005. The department has a digital x-ray system with wireless detector technology and a portable high definition ultrasound unit. Two senior radiographers supported by a consultant radiologist constitute the team of the radiology unit.  It has continued to play a supportive role in the investigation and management of patients with various conditions requiring radiology both for diagnosis and for treatment.

The cardiology unit supports the clinics in conducting electrocardiography examinations (ECG) and   echocardiography examinations. It also runs a weekly rheumatic heart disease clinic. A cardiology nurse and a medical officer with training in cardiology staff the clinic. We also have a cardiologist on call for complicated cases. The clinic has also spearheaded a number of studies and is currently conducting a Peripheral Arterial Disease (PAD) study.

JCRC dental clinic has a modern state of art dental equipment such as a modern intra oral camera, reclining chair, dental x-ray machine and an auto clave. It has new generation dental materials like Composite, Fugi ix glassionomer, Amalgam among others. We have an experienced dental officer that is supported by a dentist. The unit offers a wide range of dental services and dental procedures including:

• Root canal treatment
• Routine dental check up
• Scaling and polishing
• Dental filling
• Crown and bridges
• Orthodontics
• Extractions

JCRC has an in-patient facility with 8 self-contained rooms and 11 cubicles with shared bathroom facilities. We also have a high dependency area that has basic equipment used for managing and stabilizing critically ill patients. Because of COVID-19, we have also equipped an isolation unit on the ward for stabilizing COVID-19 infected patients who require initial critical care before referral to a treatment center. A physician and medical officer together with a team of ward nurses perform ward rounds multiple times a day on a daily basis. An in charge nurse heads the unit with a team of nurses and the unit is operational 24 hours a day.

The psychosocial department offers a wide range of services. These include pre and post HIV test counselling, Pre ART counselling as well as adherence counselling. Another core function is assisted partner notifications in which clients are assisted to notify their partners of their positive HIV status. The counselors also recruit and consent participants for all the various studies conducted in the adult and pediatric outpatient clinics. One key feature that is emphasized is the holistic approach when working with clients.

The psychosocial department currently has eleven counsellors with four stationed in the pediatric clinic, four in the adult outpatient clinic and three are specifically attached to particular studies. The counsellors work both at the facility and also participate in community outreach activities. The counsellors work with peer supporters who are “expert clients” that provide health talks in the patient waiting areas, assist in adherence counselling, calling of clients who may have missed their appointments or who have high viral loads and participating in community outreach activities.

The tuberculosis (TB) clinic is a standalone clinic with its own separate specially built structure, spacious and suitable for attending to TB patients. The TB clinic operates twice a week however screening for TB patients is conducted daily in each of the various clinics. Patients confirmed with tuberculosis are periodically reviewed in the TB clinic. Apart from TB consultations, other activities in the clinic include HIV testing, health education; sputum collection, screening for opportunistic infection and provision of drugs for the treatment of tuberculosis. The TB clinic also does community outreach activities for contact tracing. A physician, one nurse and a community volunteer who assists the team during contact tracing support the clinic.

The Joint Clinical Research Center (JCRC) has been conducting therapeutic Apheresis procedures since 2017, the only facility in Uganda so far. JCRC offers the apheresis service using a Spectra Optia Apheresis machine. Apheresis is a medical procedure that involves the drawing of blood from an individual and passing that blood through a machine that is able to separate the key individual components of the blood. The blood component of clinical interest is then removed or replaced, while the other components of the blood are infused back in the individual. 

Red blood cell exchange (RBCX) is the removal of defected, infected or excessive red blood cells and simultaneous replacing these with red blood cells or appropriate fluid while Therapeutic plasma exchange (TPE) is the removal of plasma to remove/decrease disease mediator and simultaneous replacement with appropriate fluid. Currently JCRC is conducting red blood cell exchange procedures for clients who have complications resulting from sickle cell disease (SCD) and total plasma exchange procedures for clients who present with autoimmune diseases like Guillain Barre Syndrome (GBS) or thrombotic thrombocytopenic purpura (TTP).

The Spectra Optia apheresis unit can however be used for other indications. JCRC recently acquired a second apheresis machine known as a TRIMA machine that will be used in plasma collections. We plan to use it in collection of convalescent plasma from patients recently recovered from COVID-19. This will be used for both research and therapeutic purposes for research purposes.

One stop comprehensive HIV Care and treatment center: JCRC was one of the first facilities to start offering comprehensive HIV care and treatment in sub Saharan Africa. Because of this, it has accumulated extensive experience in managing patients with HIV. It currently has a viral load suppression rate of 96% with a retention of close to 90% and having over 13,000 clients in care.

Apheresis Unit: JCRC is the only facility in the country and one of the very few in the region with the capacity to perform apheresis procedures. The directorate has modern state of the art equipment that can accurately perform apheretic exchanges (red blood cell and plasma) as well as blood cell and plasma collections.

Wellness Clinic: JCRC is among the very few centers in the country that offers a wellness program for its clients. It has specially trained clinicians and nutritionists as well as a well-equipped wellness clinic. It also offers a comprehensive range of wellness packages tailored to the needs of its clients.