Geographic Distribution

Fig. 16.1 Geographic distribution of tropical sprue.

The disease is endemic in India, Pakistan, Sri Lanka, Myanmar (Burma), Vietnam, China, Indonesia, Singapore, Malaysia, Borneo, the Philippines, Central America and northern South America (Mexico, Guatemala, Colombia and Venezuela), and several Caribbean islands, especially Puerto Rico, Haiti, Dominican Republic and Cuba (Fig. 16.1). There have been multiple case reports from the Middle East (Egypt, Israel, Lebanon, Syria and Yemen) and Africa (Uganda, southern Sudan and rarely Kenya, Malawi, Nigeria, Angola, Democratic Republic of Congo, Tanzania, Zimbabwe and South Africa).

It sometimes occurs in an epidemic form in India, Myanmar and Pakistan and has its highest prevalence in southern India.