MORE than 2,300 people have been killed in a powerful 7.8-magnitude earthquake that rocked large swathes of Turkey and Syria early today.

Thousands more were injured and the death toll is expected to rise as rescue workers search mounds of wreckage in towns and cities  hoping to find survivors.

On both sides of the border, residents were jolted out of their sleep as the predawn quake hit. 

Hundreds of buildings were flattened, and major aftershocks — including one nearly as strong as the first — continued to shake the region.

A hospital in Turkey collapsed, and patients, including newborns, were evacuated from facilities in Syria.

In the southern Turkish city of Adana, a resident said three buildings near his home had been toppled. “I don't have the strength any more,” one survivor could be heard calling out from beneath the rubble as rescue workers tried to reach him, said journalism student Muhammet Fatih Yavuz.

Turkish President Recep Tayyip Erdogan said: “Because the debris removal efforts are continuing in many buildings in the earthquake zone, we do not know how high the number of dead and injured will rise.”

The quake, which centred on Turkey’s south-eastern province of Kahramanmaras, was felt as far away as Cairo. It sent residents of Damascus rushing into the street and jolted awake people in their beds in Beirut.

The deadly earthquake struck a region that has been shaped on both sides of the border by more than a decade of civil war in Syria. On the Syrian side, the swath affected is divided between government-held territory and the country’s last opposition-held enclave, which is surrounded by Russian-backed government forces.

Turkey, meanwhile, is home to millions of refugees from that conflict.

The opposition-held regions in Syria are packed with some four million people displaced from other parts of the country by the fighting. Many of them live in buildings that are already wrecked from past bombardments. 

Hundreds of families remained trapped in rubble, Syrian opposition emergency organisation the White Helmets said in a statement.

Rescue workers said that already strained health facilities and hospitals quickly filled with the injured. Other health facilities, including a maternity hospital, had to be emptied for safety reasons, according to relief organisation the Syrian American Medical Society.

The region sits on top of major fault lines and is frequently shaken by earthquakes. Some 18,000 people were killed in similarly powerful earthquakes that hit north-west Turkey in 1999.