Islamist suicide bombers targeted markets crowded with Ramadan shoppers and a major provincial hospital in Afghanistan on Tuesday, killing at least 38 people and wounding close to 100.

The bloodshed underscored a surge in fighting ahead of a withdrawal by most Western combat troops and handover to Afghan forces winding up in 2014. NATO-led forces have been struggling to eliminate Taliban insurgent bastions, especially in the east.

Suicide bombings in markets in the southwest province of Nimroz killed at least 28 people - 18 of them civilians and three policemen - and wounded over 70, police said, in the deadliest day of violence in the normally peaceful region since 2001.

Women and children and at least three members of the Afghan security forces were among the dead in Zaranj, the capital of the largely rural province, which lies on Afghanistan's western border with Iran.

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Another bomber blew himself up in front of Zaranj hospital, while two others detonated explosive vests in other areas of the city, killing mostly civilians, President Hamid Karzai's office said in a statement.

The toll in Zaranj was expected to rise, provincial governor Abdul Karim Barahawi said. "The attackers blew themselves up in crowded markets to target civilians. There was no government installation nearby," Barahawi said.

The Achin district governor in the northern Kunduz province told NBC News that at least 10 civilians were killed and 28 were wounded in a blast from a bomb affixed to a motorcycle.

Reuters reported the blast was at a bazaar.

All the outdoor markets attacked by the bombers had been packed with people buying food and supplies to end their daily Ramadan fast, local police said.

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An Afghan policeman killed 11 colleagues in Nimroz province on Saturday, firing on them at a checkpoint in Dilaram district, adding to a recent spate of such killings that have alarmed NATO commanders and left 34 foreign soldiers dead.

This article includes reporting by Reuters and NBC's Atia Abawi in Kabul.

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