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A longitudinal serological study to investigate the seropositive frequency, incidence, and antibody dynamics of  Chlamydia trachomatis  infection in the general population of China is urgently needed in order to optimize the strategies for surveillance and precise prevention of  C. trachomatis  infection. This longitudinal study enrolled 744 subjects aged 18–65 years from Jidong Community of Northern China from 2014 to 2018. Seropositive frequency, incidence, and reinfection of  C. trachomatis  were determined by detecting antibody against  C. trachomatis  Pgp3 using “in-house” luciferase immunosorbent assay (LISA). The dynamic of anti-Pgp3 antibody was analyzed using the Generalized Estimating Equation (GEE) model. The overall Pgp3 seropositive frequency among the 18–65-year-old population was 28.1% (95% CI 24.9–31.5), and significantly increased from 12.0% in those aged 18–29 years to 48.6% in the 60–65 years old. The seropositive frequency was slightly higher in women than in men (31.3% vs. 25.4%) without statistical significance. The  C. trachomatis  incidence and reinfection rate were 11 and 14 per 1,000 person-years, respectively, and showed no significant difference with respect to age, gender, ethnicity, marital status, and education levels. Furthermore, anti-Pgp3 antibody remained detectable in 93.3% (195/209) of the seropositive subjects during the 5 years of follow-up. The overall decay rate for anti-Pgp3 antibody for CT-infected persons was −0.123 Log2 RLU/year, which was dramatically slower than in CT new infection (−3.34 Log2 RLU/year) or reinfection (−1.1 Log2 RLU/year). In conclusion, at least one quarter of the people aged 18–65 years have been infected with  C. trachomatis  over their lifetime while all age groups are susceptible to  C. trachomatis  infection in the community of Northern China. Therefore, comprehensive prevention strategies are urgently needed.

Seroepidemiology of Chlamydia trachomatis Infection in the General Population of Northern China: The Jidong Community Cohort Study