Cyclone Freddy is set to move away from land after barrelling through Mozambique and Malawi since late last week, killing hundreds of people and displacing thousands more.

The cyclone has killed at least 199 people in Malawi’s southern region and within and around Blantyre, the country’s financial hub, according to local authorities.

In neighbouring Mozambique, officials say at least 20 people have died since the storm made landfall in the port town of Quelimane on Saturday night, bringing high winds and torrential rain.

Guilherme Botelho, emergency project coordinator in Blantyre with Doctors Without Borders, said: “There are many casualties – either wounded, missing, or dead and the numbers will only increase in the coming days.”

Malawi, which has been battling a cholera outbreak, is at risk of a resurgence of the disease, Mr Botelho warned, “especially since the vaccine coverage in Blantyre is very poor”.

The aid organisation has suspended its outreach programmes to protect its staff against flash floods and landslides, but is supporting cyclone relief efforts at a local hospital.

A regional cyclone monitoring centre on the island of Reunion projects that Freddy will move back out to sea by late Wednesday afternoon.

It is unclear whether the cyclone – possibly the longest-lasting in recorded history – will then dissipate or move away from land after that.

Kim Yi Dionne of University of California Riverside said Malawi has a disaster management agency that prepares and plans for the challenges that come with the climate crisis.

“We are likely to hear of many more casualties … in the days and weeks to come.”

Cyclone Freddy has been causing destruction in southern Africa since late February. It pummelled Mozambique as well as the islands of Madagascar and Réunion last month as it traversed the Indian Ocean.

Freddy first developed near Australia in early February.

The UN’s weather agency has convened an expert panel to determine whether it has broken the record for the longest-ever cyclone in recorded history, which was set by 31-day Hurricane John in 1994.