Investigation on the satisfaction degree of scientific research environment of leprosy prevention and control personnel in China CURRENT STATUS: UNDER REVIEW

Summary Objective: To understand the situation of scientific research environment of leprosy prevention and control personnel in China, and to provide policy basis for improving its scientific research conditions, improving the scientific research ability of leprosy prevention and control, and then improving the prevention and treatment level of leprosy. Methods Through multi-stage stratified random sampling, 95 organizations and 351 leprosy prevention and control personnel were recruited. by using homemade organization interview questionnaire and scientific research environment satisfaction questionnaire. Results The overall satisfaction of the scientific research environment of leprosy prevention and control personnel in china was low (14.6%). Single factor analysis shows that the satisfaction of leprosy epidemic areas category IIwith the use of scientific research funds and the difficulty of applying for the research projects is high;and the satisfaction of scientific research at the county level and below institutions is higher than that of provincial and ministerial institutions;and the standard of scientific research award of the skin disease hospitals (Institutes) is higher than that of the CDCs. The respondents considered that the main problems at present were poor scientific research conditions, lack of scientific research and academic atmosphere, and respondents generally agreed that the construction of scientific research infrastructure was the prioritize issue that needed to be solved urgently at present. Conclusion The satisfaction of the current research environment of leprosy prevention and treatment personnel in China is not high. The construction of scientific research infrastructure and scientific research technology platform, as well as the introduction, training and reform of compensation system of leprosy prevention and treatment talents, need to be improved.


Introduction
Leprosy is a chronic infectious disease caused by Mycobacterium leprosy. 1 Although the prevalence of leprosy declined considerably in the past 50 years, this old-age and highly contagious disease remains a global endemic that can never be ignored. 2 By end of 2017, 192,713 cases of leprosy were registered globally, increased by 20,765 cases compared to 2016. 3,4 Every year, there are a large number of people with leprosy who have been undiagnosed around the world. 5 Delayed diagnosis may lead to disease transmission to others and/or progression to more serious complications. The causes of delayed diagnosis generally include the neglect of early symptoms, the difficulty of differential identification and other factors, 6 So it is necessary to develop effective early detection methods for leprosy.
In the field of leprosy control, many countries of the world have established their longterm goal of eliminating leprosy. To achieve this goal, there is an urgent need to devise customized strategies in the prevention and treatment of leprosy, which involve epidemiological studies of leprosy, development of effective tools to detect early infections, predict neurological damage and disability levels, identification of effective ways to monitor drug resistance and develop a range of basic research or health service research issues such as leprosy vaccines. 7 An effective scientific research environment is a foundation to develop high-quality scientific research for the prevention and treatment of leprosy. The purpose of this paper is to investigate the current situation of leprosy prevention and control institutions in scientific research management system, guarantee support, scientific research work hardware and software environment, and provides the policy basis for improving the scientific research environment of leprosy prevention and control personnel.

Sampling Method
Through multi-stage stratified random sampling, 18 provinces, including Shanxi, Sichuan, Guangxi, Hunan, Guizhou, Yunnan, Jiangxi, Zhejiang, Jiangsu and Anhui, were selected in the present analysis. According to the National Plan for the Elimination of Leprosy Hazards (2011-2020), it categorized 31 provinces, municipalities and autonomous regions in mainland Chinese into three types of epidemic areas by the prevalence and incidence rate of leprosy. The first category includes Jiangxi, Hunan, Guangxi, etc. The second category includes Jiangsu, Zhejiang, Anhui, Fujian, etc. The third category include Beijing, Tianjin, Hebei, Shanxi, etc. 8 In this study, 7 provinces were classified as leprosy epidemic areas category I, 9 provinces were category II and 2 provinces were category III. The respondents included the heads of agencies such as CDCs, skin disease hospitals(institutions) and leprosy hospitals (villages); middle-level cadres and general staff.

Source of information
This analysis adopted a mixed qualitative and quantitative approach through questionnaire survey and qualitative interview. Through reference to the relevant previous studies in the literature and expert consultation, we designed a questionnaire on the satisfaction of scientific research environment and an interview guide for the institution of leprosy prevention and control.
In addition to collecting the basic situation of the respondents' leprosy epidemic areas, the level and nature of institutions, job categories, etc., the questionnaire on the Written informed consents were obtained from all participants.

Data statistics and analysis
All statistical analyses were performed by using SPSS21.0 and MS-EXCEL for Windows.
Descriptive statistics were used to describe respondents' satisfaction of the scientific research environment by four potential factors, such as different epidemic areas, the level and nature of institutions, job categories. This paper compared the difference in satisfaction level of the scientific research environment with each potential factor using one-way ANOVA and then Scheffe post hoc test method for the groups with significant difference. In the case where the overall test F value reached significant, but the post hoc test was not significant, Tukey's honestly significant difference (HSD) post hoc test was applied. The significance level for all statistical analyses was 0.05%.
Ranking questions were analyzed by assignment score, taking the example of " the issues that should be prioritized in the scientific research environment ". Concrete steps: (1) by the interviewees through the subjective experience of the current scientific research environment to screen out the most needs to solve the problem, and according to the importance of sorting, 1 indicates the first need to solve the problem, 2 indicates the second need to solve the problem, and so on, (2) each issues in descending order, the first problem to be solved is assigned a value of 8 points The second problem that be solved is assigned a value of 7 points, and so on; the assignment without tick is 0; and (3) the total score of the problem needs to be solved, sorted by score. [ Figure 1]

Satisfaction of scientific research environment
Among the 351 survey respondents, their overall satisfaction of the current scientific research environment was not high (see Table 1). Among them, 30.5% (n = 107) rated as "not satisfied"/ "not very satisfied"; 55.0% (n = 193) rated as "general"; and only 14.6% (n = 51) rated as "more satisfied"/ "very satisfied".
[ Table 1] As illustrated in Table 2, the average score of the respondents' satisfaction with the scientific research management of the unit was the highest at 2.95 (SD = 0.86) and Satisfied with the research funding of the research group was the lowest at 2.38 (SD = 0.96).
[ Table 2] One-way ANOVA of satisfaction evaluation of various factors in scientific research environment by respondents with different characteristics Table 3 shows the results of one-way ANOVA showed that certain items of satisfaction in scientific research environment were significantly different across different epidemic areas, the level and nature of institutions. Result of Scheffe post hoc test found that the average satisfaction score of the research funding of the research group, leprosy prevention and control personnel' respondents in epidemic areas of Category Ⅱ and Ⅲ was higher than those in CategoryⅠ(F = 6.419, p = 0.002). the average satisfaction score of the difficulty of applying for current research projects, category Ⅱ areas was higher than Category Ⅰ(F = 4.436, p = 0.013). For the average satisfaction score of the current scientific research environment, respondents from the county level and below institutions was higher than that of the staff at the provincial and municipal levels (F = 5.278, p = 0.006). Using HSD post hoc tests, it is found that the average satisfaction score of the unit's science and technology award criteria for respondents from the skin disease hospitals (Institutes) was higher than that of the CDCs (F = 4.123, p = 0.017) ( Table 3).
[ Table 3] Analysis of the issues that should be prioritized in the scientific research environment.
By summarizing the issues that 351 respondents thought were most needed to be solved in the course of scientific research, they sorted them according to the number of people selected (Table 4)  The research shows that the evaluation of the use of scientific research funds of the research group, leprosy epidemic areas category Ⅱand category Ⅲ is higher than that category I. On the evaluation of the difficulty of applying for current scientific research projects, the satisfaction rate of the leprosy epidemic areas category Ⅱ is higher than category I. The evaluation of the academic atmosphere and scientific research environment of the institutions, the satisfaction of the personnel of the county level and below institutions is higher than that of provincial and municipal institutions. which is because the important scientific research tasks were taken by the municipal and provincial level leprosy prevention and control institutions, but the relatively light situation of the county level and below leprosy prevention and control institutions.
China has attained great achievements in the control and elimination of leprosy, the overall incidence of leprosy is currently low, then the prevention and treatment of leprosy is often neglected by society. The social status of the Leprosy worker universal lower, especially in the skin disease hospitals (Institutes), Leprosy prevention and treatment personnel and other medical personnel engaged in the diagnosis and treatment of dermatology people compared to not only lower incomes, expertise limited, and promotion path will be affected. This survey found that leprosy prevention and control personnel on the scientific and technological reward standard satisfaction evaluation, skin disease hospitals (Institutes) than the CDCs higher.
According to the findings of this survey, combined with our goal of further eliminating leprosy and trying to play China's role in the global goal of "creating a world free of leprosy". 12 It is recommended that relevant government departments for leprosy prevention and control should take the following measures.
To improve the importance of leprosy prevention and control scientific research work and improve the urgency of leprosy prevention and control scientific research environment knowledge. Decision-makers at all levels and leprosy prevention and control institutions should fully realize that scientific research on leprosy prevention and control is an important means of leprosy prevention and control.
To effectively increase support for leprosy prevention and research work, strengthen the resource allocation of leprosy prevention and control scientific research. This includes an increased investment on human capital, financial and non-financial resources, which focus on supporting and organizing highlevel, original, combined with China's leprosy prevention and treatment of practical basic research and multi-center, large sample clinical trials to ensure leprosy prevention and treatment research work sustainable development.
Strengthen the classification guidance for leprosy prevention and research, focusing on supporting national sub-centers and regional priorities leprosy illness prevention and control of scientific research institutions, play each institutions advantage. At the same time, we should establish a system and institutional operational mechanism that is conducive to the prevention and control of leprosy, especially to foster multidisciplinary and multi-center research, and encourage the participation of the majority of grass-roots leprosy prevention and control personnel in clinical research. Work on the initiative to improve the output and efficiency of leprosy prevention and treatment research.
Introduction of relevant policies to promote leprosy prevention and control of scientific research personnel treatment and status, attracting high-level talents to participate in leprosy prevention and research work, thus enhancing our country the level of scientific research in the prevention and treatment of leprosy.
There are some limitations in this study. This study analyzed self-rated satisfaction level of the scientific research environment and major difficulties of the personnel affecting leprosy prevention and control, and lacks empirical evidence on the causality that causes the difference in satisfaction, we hope to carry out further research in the future. To the best of our knowledge, this is the first study of the scientific research environment of leprosy prevention and treatment personnel in China. Despite its limitations, this study has great significance for improving the situation of the scientific research environment.

Funding
The study was financially supported by the China Association for Science and Technology  Description: A1-categoryⅠ, A2-categoryⅡ, A3-category Ⅲ  Description: A1-category Ⅰ, A2-category Ⅱ, A3-category Ⅲ; B1-Provincial and ministerial level, B2-Municipal level, B3-County level and below; C1-CDCs, C2-skin disease hospitals (Institutes), C3-Leprosy Hospitals(villages) and others The enthusiasm of young researchers to participate in scientific research 1274 4 Reform of science and technology Policy and scientific and technological legislation 1121 5 Research Results/Job Title evaluation system 981 6 Improving the moral quality of scientific research personnel 956 7 The flow mechanism of scientific research talents 605 8