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The two largest regional fluoride cool spots dominated the major and minor rift escarpments in the west and east of the study area respectively while the small ones emerged around the volcanic mountains in the north and south. Furthermore, significant spatial outliers emerged at the boundary of regional fluoride hotspots and cool spots as an indication of the spatial processes controlling the mobilization of fluoride in groundwater. While all water sources in the cool spots had fluoride concentrations below 1.5 mg/L, some had extremely