CAIRO (AP) — Famine is spreading in war-torn Sudan ’s western Darfur region and has now engulfed two more towns there, a global hunger monitoring group said Thursday. The announcement came only months after the group said people in Darfur’s major city of el-Fasher were enduring famine.

The Integrated Food Security Phase Classification, or IPC, said in a new report that famine has now been detected in the towns of Umm Baru and Kernoi in Darfur. The group in November said el-Fasher was enduring famine and also the city of Kadugli in South Kordofan province. At the time it said 20 other areas across Sudan were at risk of famine.

The report came as an attack on Thursday by the paramilitary forces on a military hospital killed 22 people, including the hospital’s medical director and another three medical staff members, and wounded eight people in the town of Kouik in South Kordofan, the Sudan Doctors’ Network, a group of medical professionals tracking the war said.

Since April 2023, war has gripped much of Sudan after a power struggle between the African country’s military and the powerful paramilitary Rapid Support Forces erupted. The conflict has triggered what the United Nations’ calls the world’s worst humanitarian crisis.