Abstract
INTRODUCTION: Informal settlements along French Guiana's coastline are characterized by precarious living conditions and limited access to water, hygiene, and sanitation (WASH), increasing residents' vulnerability to infectious diseases. This study assessed knowledge, attitudes and practices (KAP) regarding WASH-related diseases to inform targeted health promotion interventions. METHODS: A sequential explanatory mixed-methods cross-sectional study was conducted from May to July 2023 in four informal settlements in Cayenne, Macouria, Matoury and Remire-Montjoly. Quantitative data were collected through an interviewer-administered survey, and qualitative data were gathered via focus group discussions to explore and contextualize the survey findings. This sequential design allowed qualitative findings to explain patterns observed in the quantitative data and to provide insights into contextual factors influencing residents' behaviors. RESULTS: A total of 364 residents participated (exceeding the initially calculated sample size of 332). Participants had a mean age of 39.9 years [±12.97], and 60% were women. Most participants (98%) were born abroad, mainly in Haiti (84%). Nearly half (46%) reported consuming non-potable water and only 5% treated it correctly with disinfectants. Knowledge of diarrheal diseases was high (93%), whereas awareness of vector-borne and zoonotic diseases was low (14% for dengue fever; 35% for leptospirosis). Eighty-one percent reported using both individual and collective preventive measures. Sociodemographic characteristics were not associated with KAP outcomes. DISCUSSION AND CONCLUSION: These findings highlight persistent gaps in access to safe drinking water and effective water treatment practices, as well as limited awareness of diarrheal, vector-borne, and zoonotic diseases. Together, these factors emphasize the need for targeted health promotion strategies, preventive interventions, and community-level education to reduce disease risks in informal settlements of French Guiana.