A Syrian man carries a dead girl in the town of Azmarin in the northern Syrian province of Idlib, Monday, February 6, 2023. A powerful earthquake struck southeastern Turkey and Syria early Monday morning, leaving more than 200 dead. (AP Photo/Ghaith Alsayed)

ANKARA, Turkey (AP) — A 7.8-magnitude earthquake struck southeastern Turkey and Syria early Monday, toppling buildings and sparking a frantic search for survivors in cities and towns across the vast affected area. At least 568 people were killed, thousands were injured, and the death toll was expected to rise.

On both sides of the border, tremors jolted people awake several hours before dawn and forced them out into the streets on a cold night of wind, rain and snow. Dozens of buildings collapsed in cities across the border region.

Rescuers and residents searched anxiously under the rubble, among the piles of twisted metal and concrete blocks.

In the Turkish city of Adana, witnesses said they heard a person call for help under the remains of a building. “I have no strength to endure,” the person cried. Farther east, in Diyarbakir, cranes and rescue teams worked on a pile of piled-up concrete floors that was once an apartment building.

On the Syrian side of the border, the quake rocked opposition-controlled regions that are teeming with several million displaced Syrians with a decrepit health system after years of war. At least 11 people died in the town of Atmed and many more were buried in the rubble, a local doctor, Muheeb Qaddour, said in a telephone interview with The Associated Press.

“It is feared that there are hundreds of deaths,” Qaddor said, referring to the northwestern region of the country. “We are under extreme pressure.”

The quake, which was felt in Cairo, was centered in the city of Gaziantep, some 90 kilometers (60 miles) from the Syrian border. Along with several other cities, the area is home to millions of Syrian refugees who have fled their country’s protracted civil war. Turkey, which shares a border with Syria, hosts the largest number of Syrian refugees in the world.

At least 20 aftershocks were recorded, some of them hours later when the sun had already risen. The strongest one had a magnitude of 6.6, according to the Turkish authorities.

Turkish President Recep Tayip Erdogan said on Twitter that “search and rescue teams were immediately dispatched” to the affected areas.

“We hope that we will get through this disaster together as soon as possible and with the least amount of damage,” he added.

Turkish Vice President Fuat Oktay reported 268 deaths and 2,300 injuries in 10 provinces of the country. Some 1,700 buildings collapsed, he added.

The death toll in government-controlled areas of Syria has risen to 237, according to Syrian health authorities. At least 516 people were injured in Syria. Forty-seven people were also reported dead in rebel-held areas of the war-torn country.

The quake destroyed buildings from the Syrian cities of Aleppo and Hama to Turkey’s Diyarbakir, more than 200 miles (330 kilometers) away to the northeast.

In Turkey, people trying to leave the affected regions caused traffic jams that complicated the efforts of emergency teams to reach the affected places. The authorities urged residents not to take the roads. Mosques across the region were opening as shelters for people unable to return home in freezing temperatures.

The tremor caused extensive damage to Gaziantep’s best-known landmark, a historic castle on the hill in the center of the city. Part of the walls and watchtowers of the fortress were destroyed and other parts badly damaged, according to images from the city.

In Diyarbakir, rescue teams called for silence as they tried to hear the survivors of a destroyed 11-story building. Rescuers carried a man on a stretcher out of a crowd of hundreds of people who were nervously watching the operation. A woman with gray hair cried before a man escorted her to another location, while a rescuer in a white helmet tried to calm a crying girl, embraced by two friends.

In northwestern Syria, the tremor exacerbated hardship for the opposition enclave centered in Idlib province, which has been under siege for years and suffers from frequent Russian and Syrian government airstrikes. The territory is dependent on the flow of aid from nearby Turkey for everything from food to medical supplies.

The opposition group Syrian Civil Defense said the situation in the rebel-held region was “disastrous”, with entire buildings collapsed and people trapped in the rubble.

In the small Syrian rebel town of Azmarin, in the mountains next to the Turkish border, the bodies of several children wrapped in blankets were brought to the hospital.

The US Geological Survey said the epicenter of the quake was located about 33 kilometers (20 miles) from Gaziantep, at a depth of 18 kilometers (11 miles).

In Damascus, buildings shook and many people took to the streets in terror.

The quake roused residents of Lebanon from their beds, shaking buildings for about 40 seconds. Many of the inhabitants of Beirut left their houses on the streets or drove their vehicles to areas far from construction.

The quake occurred during a blizzard in the Middle East that is expected to continue through Thursday. Turkey is located in a zone of large seismic faults and registers frequent earthquakes.

In 1999, a series of earthquakes in the northwest of the country claimed the lives of some 18,000 people.

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Associated Press writers Bassem Mroue and Kareem Chehayeb in Beirut contributed to this report.

People try to reach residents trapped in a collapsed building in Diyarbakir, southeastern Turkey, Monday, February 6, 2023. A powerful earthquake caused significant damage in southeastern Turkey and Syria.  At least 138 people died, and it was feared that the number would continue to rise.  (AP Photo/Mahmut Bozarsan)
People try to reach residents trapped in a collapsed building in Diyarbakir, southeastern Turkey, Monday, February 6, 2023. A powerful earthquake caused significant damage in southeastern Turkey and Syria. At least 138 people died, and it was feared that the number would continue to rise. (AP Photo/Mahmut Bozarsan)
A collapsed building after an earthquake, Monday, February 6, 2023, in Pazarcik, in the Kahramanmaras province of southern Turkey.  (Depo Photos via AP)
A collapsed building after an earthquake, Monday, February 6, 2023, in Pazarcik, in the Kahramanmaras province of southern Turkey. (Depo Photos via AP)

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