Battles between rival warlords in Somalia's key southern port city of Kismayo killed at least 71 people last month, UN officials said on Friday, clashes Mogadishu has accused Kenyan troops of encouraging.
"Recent fierce fighting... continues to have a profound impact on civilians and humanitarian aid work in the Lower Juba region," the UN's World Health Organisation (WHO) said, adding the clashes also left more than 300 injured in June.
"Injuries and deaths outside the hospital are estimated to be much higher but cannot be confirmed," the WHO added, which supports hospitals treating the war-wounded in Kismayo.
Clashes have put on hold a vital mass polio vaccination campaign in the troubled country, where the first cases were confirmed six years after Somalia was declared free of the crippling virus.
"Kismayo remains a volatile area, with observed increase in fighting among warring factions, and other incidences of violence such as landmines and hand grenade attacks," the WHO added.
Several rival factions are battling for control of Kismayo, a strategic and economic hub in the southern Jubaland region. They include former Islamist chief Ahmed Madobe, who in May appointed himself "president" of Jubaland, and Bare Hirale, a former Somali defence minister who also leads a powerful militia.
Somalia's government has demanded that Kenyan troops stationed in Kismayo as part of an African Union force be replaced, accusing them of backing Madobe's Ras Kamboni militia, which opposes Mogadishu's rule.
Kenyan troops, which invaded Somalia in 2011, fought alongside Madobe's troops to oust Al-Qaeda-linked Shebab fighters from Kismayo in October 2012.
Kenya joined the 17,700-strong AU force in June 2012, which is mandated -- and funded by the UN and European Union -- to support the central government.
But earlier this week, Somalia released a letter from Fawzia Yusuf Adam -- Mogadishu's deputy prime minister and foreign minister -- accusing Kenyan troops of encouraging "the formation of various clan factions... hindering today the peace and stability" of the Jubaland region.
Adam said Kenyan soldiers have taken part in the fighting, including "indiscriminately" firing heavy weaponry "against other forces and against areas inhabited by civilian population".
Restive Jubaland lies in the far south of Somalia and borders both Kenya and Ethiopia. Control is split between multiple forces including clan militia, Kenyan and Ethiopian soldiers and the Shebab.
Rich in farmland, and possessing a lucrative charcoal industry as well as potential offshore oil and gas deposits, the region is also viewed by Kenya as a key buffer zone to protect its borders.
Kismayo has changed hands more than a dozen times since the collapse of the central government in 1991.