Clostridial necrotizing enteritis occurs primarily in populations with multiple risk factors, including the following: Protein deprivation (causing inadequate synthesis of protease enzymes) Poor food hygiene Episodic meat feasting Staple diets containing trypsin inhibitors (eg, sweet potatoes) Ascaris infestation (these parasites secrete a trypsin inhibitor) These factors are typically present collectively only in the hinterlands of New Guinea and parts of Africa, Central and South America, and Asia. In New Guinea, the disease is known as pigbel and is usually spread through contaminated pork, other meats, and perhaps peanuts.