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The JCRC Regional Centres of Excellence (RCES)

In order to combat the HIV /AIDS disease country wide, JCRC established seven Regional Centres of Excellence (RCEs) across Uganda. Six of these RCEs were established under the decentralised system of antiretroviral therapy roll-out program implemented between Dec 2003 and Sep 2010, with an objective of effective coordination of the various aspects of the ART roll-out exercise in the country and ensuring a comprehensive laboratory support to the national ART program. These centres included; Mbarara, Fort Portal, Kakira in Jinja, Mbale, Gulu, Kabale and Mubende. Mubende, Kakira and Kabale were eventually handed over to the Ministry of Health.

These RCEs serve their respective mapped regions as regional headquarters providing care and laboratory services, technical support in key program areas, training, support supervision, monitoring & evaluation, research and supporting the districts to achieve their HIV strategic goals and objectives. The departments at the RCEs mirror the organizational set up at the headquarters albeit smaller number of staff. Currently, the scope of work for the RCES is under review with the main focus being on Research following the end of the Pep far supported TREAT program and the phasing out of the THALAS activities at regional levels.

RCEs serve their roles in their respective mapped regions as regional headquarters providing tertiary care, laboratory services and technical support in key program areas with JCRC Lubowa as the headquarter.

JCRC FORT PORTAL Regional Centre of Excellence

Overview

JCRC Fort Portal RCE is located in Western Uganda in Fort Portal town within Buhinga hospital serving seven districts of the Rwenzori region including Kabarole, Kyenjojo, Bundibugyo, Kibale, Kasese, Hoima and Kamwenge. The clinic started in 2001 and in 2003 JCRC started on a service for a fee arrangement (cash and carry) until 2004 when the TREAT program commenced. On 10th September 2005 Fort portal Clinic was elevated to a regional centre for excellence and currently, 19 staff.

Among other achievements, the RCE partnered with the Ministry of Health to carry out DNA PCR testing for infants for the Rwenzori region. The RCE also works with a number of HIV prevention partners in the region with whom JCRC signed memoranda of understanding in the provision of various services including Laboratory services, and capacity building for Health care workers in HIV/AIDS care and management.

Activities

  • Operational Research: the site is currently participating in the implementation of the PEDO study, LIVING studies. Other just concluded studies include; REALITY, Monitoring Antiretroviral Resistance in Children (MARCH), The African Studies to Evaluate HIV/AIDs Resistance in Africa (PASER-M studies), The Europe-Africa Research Network To Evaluate Second-line Therapy (EARNEST) and Affordable Resistance Testing in Africa (ART-A), the completed the JCRC Children's Study (JCS) and the NVP-Saliva Studies.
  • HIV patient care: The current clinical care services at the RCE include Pharmacy to support the research activities, Advanced Clinical Care, Laboratory investigations, Counselling and Adherence, TB monitoring and treatment, treatment for Opportunistic Infections and Health education talks.
  • Laboratories: The centre has specialized advanced laboratory services that support among others HIV diagnostics and monitoring. These include chemistry, virology, haematology, microbiology and immunology.

The JCRC Mbale Regional Centre of Excellence

Overview

JCRC Mbale RCE is located in the Eastern town of Mbale right in the heart of the town and is currently housed in the ministry of health hospital building along Pallisa road. The RCE was established in 2002, and started as a small JCRC outreach unit, operating in 3 small rooms with two support staff. The main reason for its establishment was to expand antiretroviral treatment to the rural communities of Uganda. Currently, the centre has a fully fledged laboratory, Pharmacy data unit and administrative wing. The infrastructure centre is currently mainly supporting the research activities in the region with future plans of establishing comprehensive clinical care services.

Mbale RCE also collaborates with other HIV care partners including The AIDS Support Organization (TASO), AIDS Information Centre (AIC), among other local NGOs and CBOs.

Activities

Patient Care: The RCE currently provides antiretroviral therapy for both first and second line treatment, pain management and management of opportunistic infections. Pre-test and post test counselling and ART adherence counselling are also done.

Laboratory services: The site participated in the implementation of the REALITY study. With a state of the ART laboratory in place the RCE is empowered to offer a whole range of diagnostic and monitoring laboratory tests including CD4, DNA, HIV Rapid and ELISA testing, HIV drug resistance, and Syphilis tests, among others. The microbiology laboratory at the site is able to perform TB screening (sputum analysis for AAFBs), the autoclave for waste disposal is fully functional. Other laboratories at the site include virology, haematology, chemistry and immunology.

Operational research: Two multi-site clinical trials protocols are currently being implemented at the RCE: Pharmaccess African Studies to Evaluate HIV-Drug Resistance Monitoring (PASER) and Monitoring Antiretroviral Therapy in Children (MARCH). The Europe-Africa Research Network to Evaluate Second-line Therapy (EARNEST) study which have been completed. The site has participated and completed the JCRC Children's Study (JCS) cohort.

The JCRC Gulu Regional Centre of Excellence

Overview

The JCRC Gulu RCE is located in Koro Sub-County, about 4Km from the Gulu town district of Northern Uganda. The RCE commenced operation in 2004 as a collaboration between JCRC and Ministry of Health in Gulu Regional Referral Hospital to scale up ART provision among the disadvantaged impoverished communities of the war-torn area in Northern Uganda. As a result, over 7000 patients benefited from the HIV care services provided at the RCE, of which 1800 accessed free ART medication, Opportunistic infection treatment, counselling services and Laboratory services.

Activities

Operational Research: The RCE participated in data collection for the JCRC Children Study (JCS) and was one of the best recruiting centres for the EARNEST trial that enrolled clients failing on first line ART regimens.

Laboratory Services: The reference laboratory for the northern region that supported the REALITY study. Some of the partners accessing services from the centre include among others; Lacor Hospital, Gulu Independent Hospital, Watoto Church and TASO.

JCRC Mbarara Regional Centre of Excellence

Overview

Mbarara RCE is located in the south western Uganda, about 270km from Kampala and located within Mbarara Regional Referral Hospital/University Teaching hospital. The RCE started operating as early as 1999 but was officially opened in June 2006 by the then United States ambassador to Uganda H.E Stephen Browning. The centre was opened with support from the TREAT project, a USAID-funded programme and it supported over 19,000 patients.

The RCE collaborates a number of implementing partners including among others; Mbarara Regional Referral Hospital, TASO Mbarara, EGPAF, Italian Lab, Kabwohe Clinical Research Centre among others.

Activities:

Laboratory services: With a state of the ART laboratory in place, the RCE is empowered to offer a whole range of diagnostic and monitoring laboratory tests including CD4, DNA, HIV Rapid and ELISA testing, Syphilis tests, among others.

Operational research: The centre has also participated in the recently concluded The REALITY and EARNEST and the Cryptococcal Optimal Antiretroviral Therapy Timing (COAT) studies. The site also participated and completed the JCRC Children's Study (JCS) cohort.