Background: Tuberculosis is a prominent problem in developing countries. Hence, there isrna need for rapid, practical and accurate diagnostic tools that are adapted to resource-poorrnsettings in order to ensure that those affected receive proper and timely treatment. LightEmitting-Diodernmicroscopyrn(LED)rnhasrnrecentlyrnbeenrnendorsedrnbyrnthernWHOrnforrndiagnosisrnofrnrnTBrnrnin these countries. A much recent smear diagnosis method, PREVI FLUO TB by usingrnLED microscopy, has been made available. However, due to the novelty of the method,rnthere is no information available on the specificity and sensitivity when compared tornestablished methods such as the ordinary LED -Auramine O or the classical widely usedrnZiehl-Neelsen (ZN) in TB and TB-HIV co-infected persons.rnObjective: The study was undertaken to compare the sensitivity, specificity, PPV and NPVrnof PREVI Fluo TB stain with ZN method and Auramine O- LED microscopy. rnMethods: A prospective cross sectional study was conducted in St. Paulâ€Ÿs MillenniumrnMedical College, Addis Ababa, Ethiopia from October/2011-April/2012. Spot-MorningSpotrnrnsputum samples from 248 TB suspected study participants were collected. A total ofrn2,232 slides were made of which 744 slides were subject to be stained by each method.rnConfirmation was made by Lowenstein-Jenssen (LJ) culture which was used as a referencernstandard. rnResults: The smear detection rate of PREVI Fluo TB, ZN, Auramine O and culture werernfound to be 35 (14.1%), 24(9.7%), 44(17.7%) and 30(12.1%) respectively.The sensitivity ofrnthe PREVI Fluo TB method was 76.67%, better than ZN and slightly less than Auramine Ornwhich were 59.07% and 78.13% respectively. Nevertheless, the specificity (94.5%) wasrnlower than ZN (96.79%) and higher than Auramine O (91.2%). The negative likelihood ratiornof PREVI Fluo TB, ZN, and Auramine O methods were 0.25, 0.45, and 0.24 respectively.rnThe PREVI Fluo TB method had a PPV of 65.71% which is higher than the Auramine Orn(56.82%) but with a comparable NPV (96.71% and 96.57% respectively). The respectivernagreements of the ZN, Auramine O and PREVI Fluo TB methods with the gold standardrnwere K=0.585, K=0.621 and K=0.664. There was a substantial agreement of PREVI FluornTB result with ZN (k=0.636) and Auramine O methods (K=0.745). rnConclusion: The PREVI Fluo TB fluorescent staining method had nearly identicalrnsensitivity compared to the conventional Auramine O and significantly higher sensitivityrnthan ZN staining method. Given the practical benefits of PREVI Fluo TB for TB diagnosis,rnand comparable accuracy to the current standard of Auramine O fluorescence method andrnthe gold standard culture, PREVI Fluo TB should be considered by TB diagnosticrnlaboratories, as an alternative diagnostic tool for conventional Auramine O fluorescent stain.