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Recurrent infections over a lifetime result in scarring of the conjunctiva, the lining of the within of the eyelids. Children in trachoma-endemic communities are more likely than adults to end up being contaminated. Identifying factors that increase the threat of trachoma in kids is therefore vital to the World Health Organization's goal to eradicate trachoma by 2020. Understanding the factors that may raise the risk of serious trachoma in kids is paramount to developing effective means of preventing the eye disease, said the study's lead investigator, Sheila West, Ph.D., of the Wilmer Eyesight Institute at Johns Hopkins Hospital in Baltimore. For the study, Dr. West and her colleagues examined the optical eyes of 5240 kids in 4311 households in Kongwa, Tanzania, and found that children who slept in an area with a cooking fire were almost twice as likely to have active trachoma, and four instances as more likely to have severe trachoma, compared to kids who slept in a room with ventilation and without a cooking fire.