At least 12 people have been killed in a crowd crush at a stadium in Madagascar's capital Antananarivo, Prime Minister Christian Ntsay says.
Another 80 people were hurt during the opening ceremony of the Indian Ocean Island Games at the Mahamasina stadium.
"There were a lot of people at the entrance," Red Cross official Antsa Mirado told the AFP news agency.
President Andry Rajoelina, who was at the stadium, said it was a "tragic event", calling for a minute's silence.
The Mahamasina stadium - with a capacity of nearly 41,000 - is reported to have been packed with spectators.
Footage has emerged showing a number of injured people sitting dazed on the ground. Other victims are seen being carried away from the stadium.
Set up in 1977, the Indian Ocean Island Games is a multi-sport event held every four years.
The participants are the island nations and territories of Comoros, Madagascar, Mauritius, Seychelles, the Maldives and Réunion.
In 2018, one person died and nearly 40 others were injured in a crush at the Mahamasina before the start of a Madagascar-Senegal football match.
In 2016, two people were killed and about 80 injured in a grenade explosion at the same venue during Madagascar's national day celebrations. The blast happened during a free concert.
Two years earlier, a grenade explosion killed a toddler and injured several other people outside the same stadium.