Escalating lashes between rival militias in Libya’s capital killed at least 57 people and left residents trapped in their homes Tuesday, unable to escape the violence, medical authorities said.

The Libyan Medical Emergency Center announced on Wednesday that 230 families in the eastern and southeastern neighborhoods of Tripoli, the capital of Libya, left these areas following the escalation of conflicts.

At least 57 people have died in armed clashes between rival Libyan factions in Tripoli, medical officials said on Wednesday.

The violence, which erupted on Monday, has resulted in over 140 injuries. A ceasefire brokered by the national unity government took effect on Wednesday morning.

A spokesman for the Center for Emergency Medicine and Support, Malek Marsit, did not clarify whether the dead were civilians or militiamen.

The clashes, which began on Monday night after the leader of the 444 Brigade Mahmoud Hamza was detained by the rival Special Deterrence Force, mark the year’s most severe outbreak of violence.

The bloodshed follows a period of relative calm as Libyan political actors work towards general elections and returning stability to a country that has been at war since dictator Muammar Gadhafi’s ouster and death in 2011.