Ten people were killed and dozens more wounded Sunday in clashes on Nicaragua's Pacific coast between security forces and anti-government protesters who were blocking roads, human rights group ANPDH said.

"There are six dead in Masaya, two dead in Diria, and two in Catarina," ANDPH Executive Secretary Alvaro Leiva told EFE.

He said that four of those killed in Masaya were police, but authorities have yet to confirm any fatalities among their ranks.

In Diria, according to Leiva, "combined forces" comprising police and pro-government paramilitaries dragged father and son Almer and Allan Morales out of their home and executed them.

The dead in Catarina include a 10-year-old girl who suffered a bullet wound and died due to lack of medical attention, the activist said.

Residents in Catarina took 11 paramilitaries prisoner, Leiva said.

Masaya remains under siege by combined forces and efforts are underway to create a "humanitarian channel" to evacuate the wounded to Managua, 28km (17mi) away, according to Leiva.

The government of President Daniel Ortega accuses the road-blocking protesters of using violence to disrupt the constitutional order and says that authorities have an obligation to ensure the freedom of movement.

Human rights organizations say that at 351 people have died in unrest that began in mid-April with protests against a government proposal - since withdrawn - to make changes to the pension system.

Protesters are now demanding the resignation of Ortega, who was re-elected in 2016 with more than 70 percent of the vote.