Background: Malaria is a major public health problem affecting people, with 107 countries having areas at risk of transmission containing close to 50 percent of the world’s population. In Uganda malaria is the most common disease and a leading cause of mortality. Since 2006, the Uganda Ministry of Health together with Non Governmental Organizations have promoted and donated ITNs to vulnerable groups of people but the malaria occurance has remained prevalent among slum dwellers of Kampala and no study has been done on the factors influencing proper and regular use of ITNs among these dwellers. Main objective: To investigate factors affecting proper and regular use of Insecticide Treated Nets among slum dwellers of Katanga and Kivulu in Kampala. Methodology: A census of 289 households which had at least one ITN was conducted in Katanga and Kivulu slums. The household heads were asked whether they possessed at least one ITN in the house in order to include or exclude the household. A questionnaire that had questions on socio-demographic characteristics, knowledge and practice of the respondents on ITNs was administered. An observation of state of ITNs was done for the households that owned them. Univariate, bivariate and Multivariate logistic regression statistical analyses were used in the study. Results: Of 289 surveyed households, 109 (37.7%) were proper ITN users compared to the 180 (62.3%) improper ITN users. Out of the 289 respondents 187 (64.7%) reported to be regular ITN users compared to the 102 (35.3%) irregular ITN users. Most of ITNs that were being used had holes 180 (62.3%) and this was considered improper use while 109 (37.7%) nets had no holes. The high proportion of torn ITNs suggests there is very limited protection against mosquito bites at night and therefore a high risk of malaria transmission. The problems reported for improper and irregular use include; ITNs causing excessive heat, suffocation, discomfort and itching, insufficient nets, inadequate space, difficulty in hanging the net, torn ITNs, size and shape of ITNs. At a bivariate analysis, Gender was associated with irregular use of ITNs (P=0.017), problems like ITNs causing itching and discomfort had significant association with improper use (P=0.023). At bivariate and multivariate level of analysis, the rest of the variables such as age, education level, occupation, marital status, heat and suffocation caused by sleeping under ITNs were found to have no significant relationship with both proper and regular use of ITNs (P>0.05). Despite the fact that respondents had a high knowledge on; how malaria is transmitted at 91%, how malaria is prevented at 88.9%, how ITNs prevent malaria at 96.5% and how frequent to use ITNs at 94.8%, they were still improperly and irregularly using ITNs. Conclusion: Reported and observed factors such as torn ITNs, insufficient ITNs, inadequate living space, shape and size of the ITNs, difficulty in hanging the net, excessive heat, itching and discomfort caused by sleeping under a mosquito net, have contributed to improper and irregular use of ITNs in Katanga and Kivulu slums and this explains the increasing malaria incidences in these areas. Therefore, KCCA, donor projects, organizations together with the Ministry of Health should frequently educate slum dwellers on how to properly and regularly use ITNs if success in reducing malaria related morbidity and mortality is to be registered in Kampala slums.

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