Comparison of fresh versus sodium acetate acetic acid formalin preserved stool specimens for diagnosis of intestinal protozoal infections

The use of sodium acetate acetic acid formalin (SAF)-preserved stool specimens was compared with that of nonpreserved specimens for the recovery of intestinal protozoa. A total of 247 patients, 170 with diarrhea of more than one week's duration and 77 refugees, were asked to collect a stool specimen, Each specimen was placed into two vials, one empty, the other containing SAF fixative. Laboratory investigations included microscopic examination of the concentrated sediment and direct wet smears from both types of stool specimens and the microscopic examination of a permanent stained smear from the unsedimented, SAF-preserved stool specimens. Examination of SAF-preserved stool specimens revealed intestinal protozoa in 149 of the 247 patients. With the conventional procedure using unpreserved stool specimens, intestinal protozoa were found in 89 of the 247 patients. The results show that the examination of SAF-preserved stool specimens, consisting of the microscopic examination of both the concentrated sediment and the permanent stained smear from the unsedimented material, increases the chance of recovering intestinal protozoa as compared to the conventional procedure.