The number of civilians who have fled Syria's civil war has almost doubled to more than 230,000 following the conflict's deadliest month yet, the UN refugee agency said yesterday, as it warned that number would rise further still.

Weeks of heavy fighting in the commercial hub of Aleppo and increased use of airpower by government forces led to the departure of 103,416 people during August – almost doubling the total number of registered refugees.

Activists from the Local Coordination Committees of Syria counted 4,933 civilian victims during August, making it the highest monthly death toll in the country's 17 month-long civil war.

The UN High Commission for Refugees (UNHCR) said yesterday that 235,000 people have sought asylum in neighbouring countries since the beginning of the conflict. It added that the number is likely to be much higher as many have not registered with the agency or have other means of support.

The dramatic increase in the number of people leaving the country was described as "astonishing" yesterday by UNHCR spokeswoman Melissa Fleming. "This is a significant escalation in refugee movement," she told a news briefing in Geneva. "This probably points to a very precarious... situation in the country."

Ariane Rummery, another spokeswoman with the agency, said the UNHCR did "not see any indication" that the number of people fleeing will fall. "Many of them need everything, including shelter, healthcare, food, money and clothes," she told The Independent from Jordan, where more than 1,000 Syrians are entering the country every day.

The figures were released on the same day as the head of the International Committee of the Red Cross (ICRC) met with the Syrian president Bashar al-Assad in an effort to improve the flow of humanitarian aid to civilians still in the country. The ICRC described the meeting in Damascus as "positive."

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