A stampede of sports fans trying to enter Madagascar's national stadium for the opening ceremony of the Indian Ocean Island Games has killed 12 and injured around 80, the prime minister said on Friday.
It was not immediately clear what caused the stampede, but at least 15 people were killed in a similar incident at the Mahamasina stadium in 2019.
Prime Minister Christian Ntsay said 11 of the injured were in a critical condition.
The Indian Ocean Island Games were created by the International Olympic Committee (IOC) in 1977, and include athletes from Mauritius, Seychelles, Comoros, Madagascar, Mayotte, Réunion and the Maldives.
50,000 spectators
The stampede occurred at the entrance to the Barea stadium where a crowd of around 50,000 spectators had arrived to attend the opening ceremony of the Indian Ocean Island Games.
The cause of the tragedy was not immediately known but the Red Cross said the toll could climb.
"There were a lot of people at the entrance, which triggered a stampede," Antsa Mirado, a communications manager with the Red Cross, told AFP news agency.
Madagascar President Andry Rajoelina, who was present at the opening ceremony, called for a minute's silence.
Stands packed
"A tragic event occurred because there was pushing. There were injuries and deaths at the entrance," he said in a televised speech.
TV images broadcast images of dazed and shocked people trying to locate their shoes piled amongst objects lost in the deadly crush.
Other images from inside the stadium, shared on social media, showed the stands packed with spectators.
The Indian Ocean Island Games are a multi-disciplinary competition being held in Madagascar until September 3.
They have been staged every four years in different islands in the south-west Indian Ocean for around 40 years. The previous edition took place in Mauritius.