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In low-resource, malaria-endemic settings, accurate diagnosis of febrile illness in children is challenging. The World Health Organization (WHO) currently recommends laboratory-confirmed diagnosis of malaria prior to starting treatment in stable children. Factors guiding management of children with undifferentiated febrile illness outside of malaria are not well understood. This study examined clinical presentation and management of a cohort of febrile Kenyan children at five hospital/clinic sites from January 2014 to December 2017. Chi