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At least 45 people have been killed and 470 injured Friday in ethnic clashes in volatile southern Kyrgyzstan, heightening worries about the stability of this Central Asian nation that has been a crucial conduit for North Atlantic Treaty Organization troops and supplies into Afghanistan.

The fighting, the deadliest since the overthrow of President Kurmanbek Bakiyev in April, was concentrated in Osh, Kyrgyzstan’s second-largest city. The majority of victims have died of gunshot wounds, the health ministry said. Although government troops have intervened, clashes continue in pockets of the city.

News reports said the fighting in Osh was between ethnic Kyrgyz and Uzbek communities, suggesting a bloody reprise of ethnic fighting that occurred in the wake of the collapse of the Soviet Union, which is still fresh in the minds of many in southern Kyrgyzstan and killed hundreds.

Last month, similar fighting between ethnic groups claimed five lives in the southern city of Jalal-Abad.

The government has struggled to extend its rule in the south, a traditional stronghold of support for Mr. Bakiyev, since he fled the country in April. He was ousted after deadly clashes between government troops and opposition protesters in the northern capital of Bishkek that claimed more than 80 lives.

Government officials have suggested that allies of Mr. Bakiyev, who has taken refuge in Belarus, may be stirring up trouble in the Kyrgyzstan’s south in order to plot a return to power.

In Bishkek, the U.S. Embassy issued a statement saying it was “deeply saddened about the reports of injuries and loss of life due to violence in Osh” and urged a quick end to hostilities.

Acting President Roza Otunbayeva said the standoff in Osh started with “several local conflicts” late Thursday night and Friday morning, and that government troops then moved into the city. A state of emergency was declared early Friday in Osh and neighboring districts of Aravan, Kara-Suu and Uzghen. Ethnic Uzbek communities are largely concentrated in Osh and these districts. They also share a border with Uzbekistan.

“The tension in relations between various groups of people in this region of the country has been in place for the past few weeks,” Ms. Otunbayeva said. “At around midnight, groups of aggressive young people started gathering in the center of Osh armed with metal and wooden sticks.”

Uzbek and Kyrgyz theaters, as well as shops and police cars were set on first, the Kyrgyz prosecutor’s office said. Gunfire rang through Osh from the early morning hours into the afternoon on Friday, according to residents in Osh.

Ms. Otunbayeva dispatched defense and interior ministers, and two of her deputies to Osh to resolves the violent standoff between the two communities. Defense Minister Ismail Isakov, and Ms. Otunbayeva’s deputies, Azimbek Beknazarov and Omurbek Tekebayev are prominent politicians from southern Kyrgyzstan.

The latest violence in Jalal-Abad and Osh has raised fears that the south could see a repeat of the violence between ethnic Kyrgyz and Uzbek communities in 1990 that killed hundreds. The rise of nationalism and worsening economic conditions in the run-up to the break up of the Soviet Union led to the deadly standoff.

The unrest in southern Kyrgyzstan poses a serious challenge to the interim government’s plans to hold a constitutional referendum in less than three weeks that would make Kyrgyzstan a parliamentary republic and would confirm Ms. Otunbayeva’s term as president until the end of 2011.

The presidents of Russia and China expressed their concern over the situation in southern Kyrgyzstan Friday at a summit of the Shanghai Cooperation Organization that is being held in the Uzbek capital of Tashkent. AP

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