GENEVA, April 10 (Xinhua) -- The UN refugee agency, UNHCR, on Tuesday expressed alarm at the civilian deaths and violence in several areas of Syria and the spiraling new displacement.

"Of particular concern is the situation in Douma in Eastern Ghouta where tens of thousands of civilians remain trapped," UNHCR spokesperson Andrej Mahecic said at a UN media briefing, noting that needs extend to the most basic of items such as clothing.

UNHCR estimates that more than 133,000 people have fled Eastern Ghouta near Damascus over the past four weeks.

"This is almost three times the number we reported on March 20 and includes some 45,000 people who are currently being accommodated in eight collective shelters in Rural Damascus," said the spokesperson.

He said the UN agency's response to the Eastern Ghouta emergency encompasses the delivery of core relief items, shelter support and protection services.

Nearly a quarter of a million urgently need aid and more than 60,000 people have been reached so far.

"UNHCR is purchasing clothes locally as many people fled with nothing more than what they were wearing. In addition to a massive shelter effort, UNHCR protection partners have provided legal counseling to 22,000 people," Mahecic said.

An estimated 44,000, mainly women, children and elderly have so far been allowed to leave the collective shelters after completion of their security screening.

UNHCR teams are working with UN and NGO partners to help improve the conditions at these collective shelters, which remain congested.

"We continue to appeal to all parties to the conflict for proper protection of civilians, including freedom of movement and free choice over where to stay. Family unity must also be respected," said Mahecic.