At least 13 people, including seven children, were killed Friday in a crowd stampede at a stadium in the Madagascar capital of Antananarivo, according to the Red Cross and a local member of parliament.
"So far 13 people have been killed and 107 injured," said opposition MP Hanitra Razafimanantsoa on a local radio station.
The Red Cross, who were on the scene, added: "We don't yet have the final list. Seven minors died."
The prime minister of the Indian Ocean nation Christian Ntsay had initially put the toll at "12 dead and some 80 injured".
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.
Madagascar President Andry Rajoelina, who was present at the opening ceremony, called for a minute's silence.
"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.
Barea stadium. Reuters file picture