Snow has blanketed areas of the Middle East, with hundreds of thousands of refugees fleeing the Syrian civil war enduring freezing temperatures in makeshift shelters across the region.

In Aleppo, which is contested by rebel and government forces, the streets were strangely quiet as temperatures dropped below zero.

"All the fighters are cold and hiding," said one activist who uses the pseudonym Abu Raed.

Though in some areas there has been a lull in the combat that has raged for more than two years, the snow has increased the misery of many of the country's estimated two million refugees, who in addition to disease and malnutrition, now must endure freezing rain and blizzards.

In Lebanon's Bekaa Valley, where half of the country's refugees are crowded into approximately 250 camps, aid agencies handed out warm clothing, heating equipment, blankets and bedding.

There was not enough to go round though, and many now face the prospect of a winter in freezing temperatures with no money for fuel, in shelters made of tarpaulin or tin.

Ahmad Hasan, a 25-year-old business studies graduate living there, told The Times: "We have no heating oil, few warm clothes. We have had to hunt for scraps of wood to keep us warm. It has been terrible in every way."

Cold weather has killed nine children in Syria so far, according to activist groups.

Simon Ingram, a spokesman for the UN Children's Fund, said the agency has been able to mobilise winter supplies for Syrians in Lebanon and elsewhere but "the needs will outstrip what we and our partners are able to provide".

"The severe snowstorm this week in Lebanon and Jordan is just the beginning of winter misery for the hundreds of thousands of Syrian refugees struggling to combat the bitterly cold and wet conditions," said Nigel Timmins of Oxfam.

"Many families are facing winter in makeshift tents and unfinished buildings, unable to afford to buy fuel to run heating stoves, extra clothing or blankets. Flimsy tents are prone to flooding and are likely to collapse under the weight of snow."

Unlike in Turkey, Iraq and Jordan, the Lebanese government has refused to set aside land for Syrian refugee camps.

Many live in appalling conditions on abandoned construction sites, in slums, under bridges, or in camps squeezed between farmland.

The issue of refugees in the Lebanon is a thorny one, since many Lebanese blame the civil war of 1975-1990 on the thousands of Palestinian refugees who set up permanent camps in the country after being forced from their land by Israel, which - they say - upset the country's delicate sectarian balance.

The storm, named Alexa, has also caused snowfall in Jerusalem and Cairo.