North Korea has again come out on top of Open Door's annual World Watch List where Christians suffer the most severe persecution.
Afghanistan topped the list last year but the 2023 World Watch List released on Tuesday shows that North Korea has once again become the world's worst country for the persecution of Christians.
Following North Korea in the top 10 were Somalia, Yemen, Eritrea, Libya, Nigeria, Pakistan, Iran, Afghanistan and Sudan.
North Korea reclaimed the top spot this year due to the introduction of an "anti-reactionary thought law" that has led to "a new wave of violence" and the persecution of anyone found with foreign materials or literature.
With the exception of last year, North Korea has remained top of the World Watch List since 2002. This year, the country was given its highest ever persecution score by Open Doors.
The 'anti-reactionary thought law' has led to the imprisonment or execution of teenage boys watching South Korean shows such as Squid Game, Open Doors reports, but it is also being used to track down Bibles or any other Christian materials.
"Christians have always been in the front line of attack for the regime," said North Korean escapee Timothy Cho.
"Their aim is to wipe out every Christian in the country. There can only be one god in North Korea, and that is the Kim family."
While Afghanistan has moved down nine places since last year, Open Doors said the change in ranking "offers little cheer", with "many" Christians reported to have been executed after the Taliban's brutal return to power in 2021.
Even those who have managed to flee to neighbouring countries have faced severe challenges due to the hostility to Christians.
"Our situation is desperate," said Christian Afghan refugee, Zabi.
"My mother and I managed to cross the border into another country. I am praying that I can leave this country and go somewhere safe. I may have to go into hiding or I'll be deported to Afghanistan. If that happens, I may be killed."
The 2023 report also warns of an unfolding "catastrophe" in Sub-Saharan Africa where violence by Islamist extremists against Christians has reached "alarming" levels.
The worst of the violence is occurring in Nigeria, where Christian communities are regularly attacked by radicalised Fulani and members of the terrorist groups, Boko Haram and Islamic State West Africa Province (ISWAP).
Other acts of violence against Christians include maiming, raping, and kidnapping for ransom or sexual slavery.
According to latest Open Doors figures, religiously motivated killings in Nigeria rose last year from 4,650 to 5,014, accounting for 89 per cent of the international total.
In a worrying trend, violence that was once largely confined to the northern regions has increasingly spread into the Christian-majority south.
"The whole region is heading into catastrophe," said Frans Veerman, Managing Director of World Watch Research.
"The aim of Islamic State and affiliated groups is to destabilize the entire region, establish an Islamic caliphate - ultimately across the entire continent – and, long-term, they are confident this is within their reach. They are helped by other Islamists focusing on non-violent, systemic Islamization.
"It isn't just governments in Africa that aren't facing up to the true nature of this religiously motivated purge, it's governments across the world. The price of this denial is incalculable, not just to Africa, but to the whole world."
China, meanwhile, is witnessing the "death of universal human rights" as the rhetoric of the ruling Chinese Communist Party shifts to subjective ideas around subsistence, development and security.
"Christian minorities who are seen to oppose these new 'rights', by refusing to support the ruling party can be branded as 'disturbers of the peace' or even 'terrorists'," said Open Doors.
"They face arrest, demolition of their church buildings and the de-registering of their churches."
Further violations of religious freedom can be seen in the escalation of censorship, surveillance, data collection, and restrictions on internet use.
This year is the 30th anniversary of the World Watch List with latest figures from Open Doors revealing that over 360 million Christians worldwide suffer at least 'high' levels of persecution and discrimination for their faith.
Although there was a slight fall in the number of Christians killed for their faith, from 5,898 recorded cases last year to 5,621 this year, the number of Christians abducted for faith-related reasons rose dramatically from 3,829 recorded cases in the 2022 report to 5,259 today.