OBJECTIVES: The south Indian state of Kerala witnessed an extensive flooding during the months of August - September 2018 which was declared as level 3, calamity of severe nature, by the Government of India. The main aim of this study was to evaluate the impact of counseling and prophylactic medication adherence on preventing the incidence of communicable diseases post flood, in Indian state of Kerala.

METHODS: A community based prospective observational study using predesigned, structured questionnaire collected information from the respondents from 4 districts of Kerala, randomized on the basis of counseling provided. The responses of the flood survivors were later correlated with the data obtained from the integrated disease surveillance project (IDSP) registry of directorate of health, government of Kerala for a period from September 2018 to July 2019.

RESULTS: Among 1646 flood survivors randomized in the study, the population which received proper counseling were found to be more adherent towards prophylactic medicines (38.9% - 344 out of 884; p < 0.001) than the population with no counseling (9% - 69 out of 762). The study also revealed that good hygiene practices were 59.8%, of which 82% were counseled and 37.6% were non counseled group. On comparing the counseled group with non- counseled group, the influence of education (p = 0.002), economic standards of the family (p < 0.001) and influence of preexisting diseases (p < 0.001) is found to be vital. Correlating the study data with the IDSP data pinpoints towards the elevated rate of communicable diseases in various flood affected regions with less population receiving counseling.

CONCLUSIONS: The study indicates the need for counseling/advice to ensure proper adherence towards prophylactic medication and curb the incidence of communicable diseases.