Weather conditions were expected to improve as the storm dissipated over land after days of torrential rains, but flood levels remained high in some areas hampering emergency efforts.

People repatriate residents and their property from a flood affected Chimwankhunda location in Blantyre.
People repatriate residents and their property from a flood affected Chimwankhunda location in Blantyre. (AFP)

Rescuers scrambled to reach survivors in Malawi's battered city of Blantyre, after Cyclone Freddy struck southern Africa for a second time triggering floods and landslides that have killed more than 200 people.

"We found people in the trees, on rooftops or on higher grounds," Red Cross Malawi spokesperson Felix Washoni said on Wednesday.

"It's a challenge to reach them, water is high and bridges are broken."

Freddy returned to southeastern Africa at the weekend for a second time in less than three weeks, leaving behind a trail of death and destruction.

Malawi's government said at least 190 people were killed with 584 injured and 37 missing, while authorities in neighbouring Mozambique reported 21 deaths and 24 injured.

Rescue workers warned more victims were to be expected as they scoured destroyed neighbourhoods for survivors even as hopes dwindled.

"Four people from my family are still missing as they are buried in the mud," Alabu Wiseman, 24, said speaking from a school turned temporary shelter in Malawi.

The government said the army and police were leading search and rescue operations, which the Red Cross said would continue for at least another two days, said the Red Cross.

READ MORE: Death toll from cyclone Freddy climbs to 190 in Malawi

On Wednesday, markets and shops were starting to open again in Blantyre.

Cyclone Freddy smashed into landlocked Malawi early Monday after sweeping through Mozambique at the weekend.

The storm has unofficially broken the World Meteorological Organization's benchmark as the longest-lasting tropical cyclone on record, set in 1994 for a 31-day storm named John.

Freddy became a named storm on February 6, making landfall in Madagascar on February 21 and sweeping over the island before reaching Mozambique on February 24, claiming nearly two dozen lives in both countries and affecting nearly 400,000 people.

It then returned to the Indian Ocean and gathered new force over the warm waters, then reversed course to come back much more powerful, packing wind gusts of up to 200 kilometres per hour (125 mph).

Meteorologists say that cyclones tracking across the entire Indian Ocean are very infrequent - the last occurred in 2000 - and that Freddy's loopback was even more exceptional. 

READ MORE: 'Worst cholera outbreak in 20 years' kills over 1,000 in Malawi

Source: AFP