Asia is “the new hotbed of persecution for Christians,” with an estimated 139 million people – or one in three – found to live under “high persecution,” a persecution watchdog has revealed.

This week, Christian persecution watchdog Open Doors released its annual World Watch List of 50 countries where believers face the most persecution.

The group found that in the past five years, there has been a sharp increase in the persecution of Christians in Asia driven by the likes of a rise in Hindu ultra-nationalism in India, radical Islamism in Indonesia and tougher religious regulations in China.

North Korea continues to top the List for the 18th year in a row, with Pakistan and India marked as having “extreme” levels of Christian persecution, and the Maldives, Myanmar, Laos and Vietnam rounding out Asian countries in the top 20.

Two countries in the top 30, China and Indonesia, were both identified as areas of particular concern due to their large populations: “Each of these countries is home to more than a billion people, so these trends are distressing,” says Open Doors.

This year, China jumped 16 spots, from 43 in 2018 to 27 in 2019. The report found that more than 20 million Christians experienced persecution last year in China, and it forecasts that number to increase to 50 million in 2019.

Over the last four months, Chinese officials have shuttered three large, well-known churches: Early Rain Covenant Church in Chengdu, Ronguilli Church, and Beijing’s largest house church, Zion Church.

“The management of religious affairs lies with the Communist Party now, not just with the government, and Christians are feeling this strongly,” says the report. “Crackdowns against Christians happen country-wide and in both state-approved and non-registered churches. The youth are increasingly being removed from church life, worship is monitored via CCTV and spies, and teachers and medical workers are told they are not allowed to have any religious affiliation.”

In seven out of the top 10 World Watch List countries, the primary cause of persecution is Islamic oppression.

“This means, for millions of Christians-particularly those who grew up Muslim or were born into Muslim families-openly following Jesus can have painful consequences,” says Open Doors. “They can be treated as second-class citizens, discriminated against for jobs or even violently attacked.”

Additionally, the study found that Christian women are especially targeted around the world: “In many places, they experience a ‘double persecution’- one for being a Christian and one for being a woman,” notes the report. “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.”

In a statement, Open Doors President David Curry said that the point of the World Watch List “is to shine a light on the strength and the suffering of the family of God around the world-to drive all of us to our knees in prayer and then to our feet to stand with our brothers and sisters.”

“The World Watch List also helps us understand and see where God is at work,” he said. “Because in every country, no matter how challenging, there are Christians seeking after God. They are preaching about and living for Him, no matter what. What a powerful testimony! So please, join us in prayer that the World Watch List 2019 would mobilize believers to stand in unity with their persecuted family all around the world.”