Gaza health authorities said more than 100 Palestinians were shot dead by Israeli forces as they waited for an aid delivery on Thursday, but Israel challenged the death toll and said many of the victims were run over by aid trucks.

At least 104 people were killed and more than 280 wounded in the incident near Gaza City, Palestinian health officials said, and the death toll in nearly five months of war passed 30,000.

Medical teams said they were unable to cope with the volume and severity of the injuries, with dozens of wounded taken to the al-Shifa hospital, which is only partially operational after Israeli raids on the facility earlier in the conflict.

The incident caused the largest loss of civilian lives in weeks and was condemned by Palestinian President Mahmoud Abbas as an "ugly massacre conducted by the Israeli occupation army on people who waited for aid trucks at the Nabulsi roundabout".

Israel disputed the account provided by health officials in Hamas-run Gaza, which has been bombarded by Israeli forces for months in the war that began after the Palestinian militant group's deadly attack on southern Israel on Oct. 7.

An Israeli government spokesperson initially blamed Thursday's incident on aid trucks driven by Palestinians ploughing into the crowd in chaotic scenes.

An Israeli military official later said two separate incidents had occurred as the convoy of trucks passed into northern Gaza from the south along the main coastal road.

In the first incident, he said aid trucks had been surrounded by hundreds of people and in the confusion, dozens had been injured or killed, by being trampled or run over by the trucks. As the trucks left, he said, a second incident occurred in which some of the people who rushed the convoy approached Israeli forces including a tank, which then opened fire.

"The soldiers fired warning shots in the air and then fired towards those who posed a threat and did not move away," he told a news briefing. "From our perspective, this is what we understand. We're continuing to review the circumstances."

He said he did not believe the death toll provided by the Palestinian authorities but did not provide any Israeli estimate of how many people were killed. "I don't have any figures, it was a limited response," he said.

Ashraf Al-Qidra, spokesperson for the Gaza health ministry, dismissed the Israeli version of events. He said the latest comments showed Israel "had pre-plotted intentions to carry out the new crime and massacre", and that the death toll could rise.

Palestinian militant group Hamas, which has run the Gaza strip since 2007, said in a statement that the incident could jeopardise talks in Qatar aimed at securing a ceasefire and the release of Israeli hostages being held by Hamas in the enclave.

CHAOS

One video shared on social media, which was able to be verified as being at the roundabout, showed trucks loaded with many dead bodies, as well as wounded people.

Another video, which was unable to verified, showed bloodstained people being carried in a truck, bodies wrapped in shrouds and doctors treated injured patients on the hospital floor.

"We don't want aid like this. We don't want aid and bullets together. There are many martyrs," a man said in one of the videos.

After nearly five months of Israeli bombardments, much of the crowded enclave has been reduced to rubble and the majority of its 2.3 million population displaced from their homes at least once, leaving people heavily reliant on humanitarian aid.

Aid deliveries to northern Gaza have been rare and chaotic, passing through more active military zones to an area where the UN says many people are starving, with repeated videos showing desperate crowds surging around supply trucks.

UN and other relief agencies have complained that Israel has denied repeated attempts by them to transfer humanitarian aid to northern parts of the tiny, crowded enclave, restricting movement and communications.

Juliette Touma, director of communications at UNRWA, the main UN aid agency for Gaza, said there had been a drop of about 50% in the average daily number of trucks entering Gaza.

"So as the clock is ticking fast towards severe hunger, starvation and in some cases famine, when we should have more food aid and more humanitarian assistance coming in, and more commercial goods, we're seeing a decrease," she said, adding people were desperate and "very, very hungry".

Israel has denied any restrictions on humanitarian aid for civilians in Gaza and has said the UN is responsible for failures to deliver supplies.

On Wednesday, Israel said that a convoy of 31 trucks had moved to northern Gaza on Tuesday night and said the UN was responsible for distribution. The UN humanitarian agency OCHA said no UN agency was involved in that aid convoy.

Officials from UNRWA say deliveries have also been hampered by the refusal of uniformed municipal police in Gaza to provide security for the convoys after a number were killed in Israeli strikes.

The war began after Hamas militants stormed into southern Israel on Oct. 7, killing 1,200 and taking 253 hostages, according to Israeli tallies.

In the ensuing conflict, Palestinian health authorities say as of Thursday 30,035 Palestinians have been killed and more than 70,000 injured. Many more are feared trapped under rubble.