Open Doors USA has published its 2019 World Watch List of the top 50 countries in the world where Christians face the most extreme persecution for their faith.
While many of the top 10 countries listed this year were also on 2018's list, a significant addition was India, due to the rise in Hindu radical attacks on Christians.
"The world's two most highly populated countries rise on the World Watch List. For the first time since the start of the World Watch List, India has entered the top 10. Additionally, China jumped 16 spots, from 43 to 27," the persecution watchdog group observed.
"Each of these countries is home to more than a billion people, so these trends are distressing. Hindu nationalists in India continue to attack Christians with what seems like no consequences, and in China, the increased power of the government and the rule of Xi Jinping continue to make open worship difficult in some parts of the country," it added.
Looking at the numbers, 245 million Christians in the top 50 countries in the World Watch List are expected to face high levels of persecution in the coming year, which is an increase from the 215 million projected last year.
As many as 4,136 Christians were murdered last year because of their faith, while 1,266 churches or Christian buildings were attacked.
North Korea was listed at the very top of the World Watch List for the 17th-consecutive year, with Afghanistan, Somalia, Libya, Pakistan, Sudan, Eritrea, Yemen, Iran, and India rounding up the top 10.
Among some of the main trends, Open Doors observed what it called the "shocking reality of persecution against women."
"In many places, they experience a 'double persecution' — one for being a Christian and one for being a woman. Even in the most restricted circumstances, gender-specific persecution is a key means of destroying the minority Christian community. This kind of persecution is difficult to assess because it is complex, violent and hidden — in many cultures where women are specifically targeted, it is difficult if not impossible to report accurate numbers," the watchdog group writes.
It also noted that seven out of the top 10 World Watch List countries suffer from Islamic oppression, which is the main cause of persecution. It explained that this poses great challenges for millions of Christians who were born into Muslim families but converted and face heavy discrimination for deciding to follow Jesus Christ.