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Currently, the diagnosis of tuberculosis (TB) in Ghana relies on direct sputum smear, Ziehl- Neelsen (ZN) staining method. This method has low sensitivity and poses some health risks. The study was to compare the, direct sputum smear, (ZN) staining method against two newer ZN methods; 1% Sodium hypochlorite (NaOCL)-xylene floatation and 1% NaOCL sedimentation methods, to determine the most sensitive and the safes