Transfusion-transmitted malaria is rare, but it may produce severe problem in the safety of blood transfusion due to the lack of reliable procedure to evaluate donors potentially exposed to malaria. Here, we evaluated a new enzyme-linked immunosorbent assay malaria antibody test (ELISA malaria antibody test, DiaMed, Switzerland) Malaria can be transmitted by the transfusion of any blood component containing infected red blood cells (Mollison et al. 1997). The frequency of transfusion transmitted malaria varies from less than 0.2 in nonendemic countries to 50 or more cases per million in endemic countries (Mollison et al. 1997). Unfortunately, there is no reliable approved laboratory test to screen donated blood for malaria at present. The malaria antibody test was used for this purpose in some non-endemic countries (Seed et al. 2005). Consequently, exclusion of potentially infected donors is widely used to prevent transfusion transmitted malaria (Reesink 2005). Previous reports suggested that a malaria antibody test is effective in detecting malaria infection in travelers returning from overseas (Knappik et al. 2002) and in non-immune visitors to endemic areas after their departure (Jelinek et al. 1998, Knappik et al. 2002.In the Republic of Korea (ROK), Plasmodium vivax is the only indigenous malaria, and was almost eradicated in the late 1970s. However, it has recently reemerged, especially North in the Delimited Militarized Zone (DMZ) areas, and cases have gradually increased to 4,140 in 2000 (KCDCP 2006). In the meantime, ten cases of transfusion transmitted malaria were reported in ROK (Cho et al. 2001b, Lee et al. 2001. Because a high sero- positive rate is expected in the residents of risky areas, the application of P. vivax antibody screening of blood donors in risky areas has been often questioned. Fortunately, the prevalence of malaria is very low in the ROK as a whole. Cases are largely restricted to sparsely populated areas near the North DMZ and are most abundant in the summer. The aim of this study is to evaluate a new enzyme-linked immunosorbent assay (ELISA) malaria antibody test for malaria detection in acute stages and in follow-up after treatment. We also evaluated the ELISA test for detection of malaria infection in visitors to endemic areas. Giemsa-stained blood smears were used as a standard method. In cases where results from ELISA malaria antibody test and microscopic examination differed, polymerase chain reaction (PCR) test was used to confirm the presence of parasite. SUBJECTS, MATERIALS AND METHODS