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Famine is at risk of spreading to a third county in South Sudan in the absence of food aid, a new report from a U.S.-backed monitoring group says, with the United Nations warning on Sunday that hundreds of thousands of children could die without assistance.

The report from the Famine Early Warning Systems Network says starvation is likely to occur in Koch county in the absence of humanitarian aid.

In February, the UN and South Sudan's government officially declared a famine in Leer and Mayendit counties, with a million people said to be at risk.

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Women and children wait to be treated at a Medecins Sans Frontieres (MSF) support clinic in Thaker, Southern Unity, South Sudan, on March 20. (Siegfried Modola/Reuters)

The new report says famine is likely to spread further during the months of July to September, the lean season for South Sudan's farmers.

A man-made famine

And without the presence of humanitarian aid groups, even more parts of the country would be at risk of famine, including the southern Yei region and the eastern Jonglei area, the report says.

​The UN and others say the famine is man-made, a result of a three-year civil war that has made the country home to one of the world's largest humanitarian crises.

The fighting has blocked aid in some regions, and the government has been accused by aid groups of restricting access. Officials deny that this is the case.

'Without sustained humanitarian assistance hundreds of thousands of children are at risk of death' - James Elder, UN children's agency spokesperson

"Humanitarian access is still likely to remain volatile throughout the outlook period in many areas," the new report warns, citing the spread of conflict since fighting erupted anew in the capital, Juba, in July.

"Families have hit a tipping point, and without sustained humanitarian assistance hundreds of thousands of children are at risk of death," James Elder, a spokesman for the UN children's agency, said Sunday.

Fighting blocks aid

On Wednesday, a UN base in Leer county came under attack from the direction of the government-held town, according to the UN. There were no deaths, but aid has been limited as a result of the fighting.

"The people are hungry and deprived as the result of the famine. However, it is clear the attackers have no consideration for their plight, given those who most desperately need help will suffer more because of a likely resulting delay of humanitarian aid," David Shearer, head of the UN mission in South Sudan, said in a statement.

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