At least 398 children have been killed and more than 605 maimed since the “brutal armed conflict” in Yemen escalated on March 26, reported the United Nations children’s agency UNICEF on Wednesday.

That means that on average, nearly three children are being killed daily, and another five injured—“more than four times the number killed in 2014 and three times the number injured,” noted the report, tilted Yemen: Childhood Under Threat, adding that “the actual number of children killed or maimed could be higher.”

Among the casualties are a growing number of children who are being recruited by armed forces and other groups.

At least 377 children “have been recruited and used by parties to the conflict up to the end of July —more than double the total of 156 children in 2014,” UNICEF confirmed in the report, which was released Wednesday.

“All warring sides in Yemen are increasingly using teenage boys — who see fighting as a way to support their families financially — to swell their ranks,” indicated UNICEF, according to Reuters.

A Sunni Arab coalition led by Saudi Arabia has been targeting Iranian-allied Houthi rebels in Yemen with airstrikes and ground operations since late March in an effort to restore exiled President Abd-Rabbu Mansour Hadi, who has fled to Riyadh and has been recognized by the international community as Yemen’s legitimate leader.

More than 4,300 people have been killed in the war, most of them civilians. Disease and hunger continues to spread across the country.

“Yemen is one of the most terrifying places in the world to be a child. Children are bearing the brunt of a brutal armed conflict that escalated in March this year and shows no sign of a resolution. Scores of children are dying every month, while those who survive live in constant fear of being killed,” reports UNICEF.

“Since the escalation of fighting basic services that children depend on have been decimated. Food, medicine and water are all in short supply,” it adds. “Nearly 10 million children – 80 per cent of the country’s under-18 population — need urgent humanitarian assistance. More than 1.3 million people have been forced to flee their homes.”

Although many children are fatally falling victim to bullets and bombs, “Countless more” are at risk of death from otherwise preventable diseases and lack of proper nutrition, the U.N. report pointed out.

“As the conflict escalates, malnutrition — long endemic in Yemen – is posing an even more insidious threat to Yemen’s children,” proclaimed the U.N. agency. “Overall, around 1.8 million children are likely to suffer from some form of malnutrition in Yemen in this year alone — a total increase of almost one million children from 2014.”

“A projected 537,000 of these children will be at risk of severe acute malnutrition in 2015, which is over three times the 160,000 reported in 2014,” it continued.

The health system in Yemen is falling apart due to shortages of medicines and medical supplies, a situation that is fueling the rapid spread of communicable diseases such as malaria and dengue.

“An already fragile health system is crumbling in Yemen, leaving over 15 million people in need of basic health care. Shortages of medicines and medical supplies are severely constraining the functioning of health facilities that remain open,” reported UNICEF.

A quarter of Yemen’s 3,652 medical facilities (about 900) are no longer administering much needed routine vaccinations.

Moreover, nearly 2 million children in Yemen have no access to education.

“At least 3,600 schools have closed over the past two months, leaving 1.8 million children deprived of education,” reports UNICEF.

“This conflict is a particular tragedy for Yemeni children,” said UNICEF Representative in Yemen, Julien Harneis, adding,“Children are being killed by bombs or bullets and those that survive face the growing threat of disease and malnutrition. This cannot be allowed to continue.”