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. 2026 Feb 4;16:7299. doi: 10.1038/s41598-026-38746-7

Sexual and reproductive health consequences of COVID-19 pandemic in Nigeria: an infodemiological survey

R E Akhigbe 1,2,✉, M A Hamed 2,3,4, D H Adeyemi 5, T M Akhigbe 2,6
PMCID: PMC12923558  PMID: 41639268

Abstract

The present study analyzed the internet search behavior of common sexual and reproductive health conditions (such as sex, porn, rape, contraceptive, abortion, sexually transmitted infections, STI, erectile dysfunction, and ED) and their associations with COVID-19. This infodemiological survey employed Google Trends to analyze the internet search behavior of selected sexual and reproductive health conditions in Nigeria from October 1, 2018, to August 1, 2021, which was divided into the pre-COVID and COVID periods on March 1, 2020. The extracted data included search volume index (SVIs) for the top queried state, most populated state, rising queries, and top queries. Mann-Whitney U test was used to compare the mean SVIs for the pre-COVID and COVID periods, while Spearman’s rank-order correlation was conducted to determine the association between the sexual and reproductive health indices and COVID-19 using the SPSS statistical package. P-values < 0.05 were considered significant. The online interest in terms such as “how to rape”, “postinor”, “what is sti”, “meaning of sti”, “what is erectile dysfunction”, and “erectile dysfunction treatment” increased during the COVID pandemic compared to the pre-COVID period. Also, the SVIs for rape, contraceptive, abortion, STI, and ED reduced during the pandemic compared to the pre-COVID period. In addition, the SVI for porn increased, while that for sex was unaltered during the pandemic. SVI for COVID was positively correlated with porn but negatively correlated with rape, contraceptive, abortion, STI, and ED. The intent of rape, the need for an emergency contraceptive such as postinor, incident STI and self-diagnosis of STI, and incident ED and self-diagnosis and self-management of STI increased during the pandemic. These findings are associated with increased porn consumption as depicted by a rise in porn SVI. The COVID-19 pandemic considerably influenced internet search behavior related to sexual and reproductive health in Nigeria as shown by an increased interest in certain health queries, such as those related to sexual violence, emergency contraception, and erectile dysfunction, alongside a rise in pornographic content searches. In contrast, there was a decrease in search interest for terms related to contraception, abortion, and sexually transmitted infections (STIs). These patterns suggest a complex interplay between increased online engagement with sexual health topics and altered attitudes or behaviors during the pandemic. The findings could inform public health initiatives by highlighting emerging trends and the need for targeted health education and services in the context of evolving sexual and reproductive health concerns during and post-COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1038/s41598-026-38746-7.

Keywords: Abortion, Contraceptive, Coronavirus, ED, Porn, Rape, SARS-CoV-2, Sex, STI

Subject terms: Health care, Medical research

Introduction

COVID-19 was identified as a novel coronavirus in Wuhan, China in December 20191,2. This deadly infection rapidly spread, affecting neighboring countries3. It became a global burden and was declared a pandemic on the 11th of March 20202,4. In an attempt to halt the spread of the novel viral infection, governments around the world took unprecedented responses, which included imposed lockdowns. Although the coronavirus itself besides inducing a pneumonia-like infection has attendant complications, the lockdown following the pandemic worsened some of its associated sequelae, such as reproductive health challenges.

COVID-19 has been shown to alter the sexual and reproductive health of individuals globally5,6. Although there are conflicting reports, COVID-19 has been reported to influence sexual behaviour6–9, pornography use9–12, rape13–15, contraceptive use16,17, abortion practices18,19–21, and the incidence and management of sexually transmitted infections (STI) and erectile dysfunction (ED)22–24. In Nigeria, the pandemic was reported to be associated with increased risky sexual behavior25. The likelihood of people engaging in prolific sex chats that could spur risky sexual behavior was also doubled during the pandemic in Nigeria26,27. Ezeanya and Ogubuike28 also revealed an increase in sexual activities, masturbation, and pornography consumption among Nigerians during the pandemic. Due to the highly personal nature of sexual and reproductive challenges, it is likely that the public resorts to the use of Google25,26. Also, the impact of COVID-19 on sexual and reproductive health attracted public concern27–29 and was propagated on social media30. Thus, infodemiology is an important tool for research, decision-making, and health education31.

Infodemiology is the science of analyzing the distribution and determinants of pieces of information on the internet32. The available data is useful to monitor the online interest in health conditions, including sexual and reproductive health, and associated sequelae. Infodemiology employs data surveillance tools, such as the Baidu Index and Google Trends (GT). GT retrieves the relative amount of Google searches for specific terms based on user-determined location and timeframe33. GT provides relative search volume data, on a scale of 0 to 100 that consists of the search volume for specific terms relative to the sum of searches within the determined time frame33. Infodemiology is quite useful because it provides data on a real-time basis and web searches are performed anonymously, allowing a wider range of data-sensitive topics34–36. Using infodemiology, Ma and Ye37 demonstrated an increased search volume for condoms across American states, while Li and Tang38 revealed an increased search volume for sexually transmitted diseases in China during the pandemic.

Despite the high burden of sexual and reproductive challenges consequent from the COVID-19 pandemic and the usefulness of GT as a real-time tool, no infodemiological data on the impact of COVID-19 on sexual and reproductive health challenges in Nigeria has been reported. Also, it is important to identify the search interest of Nigerians and determine whether or not it was affected by the COVID-19 pandemic. Hence, this study was designed to analyze the internet search behaviour of some common sexual and reproductive health issues and their associations with COVID-19 using GT within Nigeria.

Materials and methods

Data collection

Nigeria is a West African country that is divided into six geopolitical zones (Supplementary Table 1). In terms of telecommunication and internet use, Nigeria has a fast-growing market with a mobile phone ownership rate of 92% among men and 88% among women, hence Information and Telecommunication section significantly contributes to the economy of the country and serves as a source of information39.

GT was employed to assess the search behaviour of some common sexual and reproductive health conditions and COVID-19 in Nigeria. The conditions analyzed were sex, porn, rape, contraceptive, abortion, STI, and ED. Queries were restricted to Nigeria and the English language. The search period was specified for October 1, 2018, to March 1, 2020, and March 1, 2020, to August 1, 2021, and these periods were referred to as the pre-COVID and COVID periods respectively. March 2020 was chosen as the mid-point because COVID-19 was declared a pandemic by the World Health Organization37 and the Nigerian government declared a lockdown at this point. The pre-COVID and COVID periods were 17 months each and were similar to the periods reported by Khosia et al.30.

GT presented the data weekly on the search volume index (SVI), a measure of relative search volume on Google. The search volume was scaled between 0 and 100, with 100 representing the peak search volume for a specific search per period. The extracted data included SVIs for the top queried state, most populated state, rising queries, and top queries for the pre-COVID and COVID periods. A search query is defined as “a word, phrase, or string of words that a user enters into a search engine”, while the top queried state is defined as “the state that receives the highest number of search queries or inquiries in a specific context, often within a particular geographic area or topic of interest”. Also, rising queries are “search terms related to a specific keyword (or overall searches if no keyword is specified) that have experienced the most significant growth in volume during a given period”, while top queries refer to “the most frequently searched terms or phrases by users in a search engine within a specific time frame” and they indicate the popular interest of the public.

Ethical statement

Google Trends data is public, non-traceable to individuals, and used solely for aggregate patterns; hence no participant consent was required since data are fully anonymised. The study was approved by the Ethics Review Committee of Oasis of Grace Hospital, Nigeria (Approval number: OGH/2021/461), and performed in accordance with the Declaration of Helsinki.

Statistical analysis

Shapiro-Wilk and Kolmogorov-Smirnov tests were conducted to test for normality. Based on the normality test outcome, the Mann-Whitney U test was used to compare the SVIs for the pre-COVID and COVID periods. Spearman’s rank-order correlation was conducted to determine the association between the sexual and reproductive health indices and COVID-19. Analysis was performed using SPSS (IBM SPSS Statistics, version 20), and p-values < 0.05 were considered significant.

Results

Online interest in sexual and reproductive health-related conditions in Nigeria during the pre-COVID and COVID periods are presented in Tables 1 and 2 respectively. For each condition, the SVIs for the top queried state, most populated state, rising queries, and top queries varied between the pre-COVID and COVID periods. Although the top queries for these conditions were similar, the SVIs differ. The SVIs for “what is rape” increased from 21 (pre-COVID period) to 31 (COVID period), “how to rape” increased in the COVID (30) period compared to the pre-COVID period (24), while “rape case” increased from 20 (pre-COVID period) to 26 (COVID period). The SVIs for “postinor” increased from 25 (pre-COVID period) to 30 (COVID period).

Table 1.

Google trend overview of reproductive health-related issues during the pre-COVID period.

Conditions Top queries state (number) Most populated state Rising queries (%) Top queries (number)
Sex

Edo (100)

Zamfara (100)

Jigawa (100)

Anambra (98)

Delta (95)

sex addiction symptoms

sex linkage (+ 700%)

sex during Ramadan (+ 650%)

sexiest woman alive (+ 480%)

sexual reproductive (+ 400%)

what is sex (100)

sex education (25)

sex during pregnancy (23)

sex and the city (21)

sex drugs (18)
Porn

Edo (100)

Anambra (97)

Delta (88)

Enugu (86)

Lagos (85)

pornograffitti extreme

pornstar martini recipe

cardi b porn (+ 950%)

sex doll porn (+ 350%)

nolly porn (+ 300%)

porn videos (100)

porn video (79)

black porn (59)

sex porn (58)

porn download (39)
Rape

Edo (100)

Enugu (94)

Anambra (94)

Borno (92)

Bayelsa (90)

Coza pastor

neymar rape

ronaldo rape case

coza rape case

pastor biodun fatoyinbo

nigeria rape (100)

rape in nigeria (50)

how to rape (24)

what is rape (21)

rape case (20)
Contraceptive

Bayelsa (100)

Oyo (90)

Imo (82)

Anambra (82)

Abia (79)

Postpill

male contraceptive pill

levonorgestrel

contraceptive meaning

contraceptive implant

contraceptive pills (100)

contraceptive pill (67)

what is contraceptive (38)

contraceptive implant (26)

postinor (25)
Abortion

Gombe (100)

Ebonyi (79)

Imo (70)

Bayelsa (66)

Kogi (62)

abortion pills name and price

abortion pill name and price in nigeria

contraceptives

misofem for incomplete abortion

how to stop bleeding after abortion pill

abortion pills (100)

what is abortion (84)

abortion drugs (77)

abortion pill (64)

misoprostol (60)
STI

Rivers (100)

Kano (92)

Oyo (84)

Abia (68)

Osun (64)

symptoms of sti in female

symptoms of gonorrhea

human papillomavirus infection symptoms

genital herpes

genital warts

sti symptoms (100)

symptoms of sti (77)

std (68)

what is sti (67)

meaning of sti (33)
ED

Anambra (100)

Kano (79)

Akwa ibom (60)

Oyo (58)

Rivers (52)

weak erection (+ 450%)

erectile dysfunction drugs (+ 70%)

erectile dysfunction solution (+ 40%)

erectile dysfunction causes (100)

erectile dysfunction drugs (78)

causes of erectile dysfunction (73)

what is erectile dysfunction (63)

erectile dysfunction treatment (60)
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STI: Sexually transmitted infections, ED: erectile dysfunction.

Table 2.

Google trend overview of reproductive health-related issues during the COVID period.

Conditions Top queries state (number) Most populated state Rising queries (%) Top queries (number)
Sex

Bauchi (100)

Anambra (98)

FCT (96)

Rivers (96)

Lagos (95)

sex education season 3 (1450%)

sexual abuse (+ 350&)

sex education cast (+ 300%)

sex virgo man aries woman download (+ 120%)

sex drugs (+ 90%)

what is sex (100)

sex education (38)

sex drugs (34)

sex during pregnancy (21)

sex and the city (14)
Porn

Anambra (100)

Rivers (96)

Bauchi (93)

Lagos (91)

FCT (90)

porn addiction books (190%)

kira kosarin porn (+ 130%)

pornography and depression (+ 120%)

tw porn star (+ 110%)

porn comic (+ 100%)

porn videos (100)

porn video (97)

porn sex (69)

porn black (61)

big porn (44)
Rape

Yobe (100)

Zamfara (69)

Gombe (68)

Anambra (68)

Katsina (65)

uwa rape

dbang rape

uwa rape victim

rape statistics in nigeria 2020

uwa the rape victim

nigeria rape (100)

rape in nigeria (64)

what is rape (31)

how to rape (30)

rape case (26)
Contraceptive

Abia (100)

Enugu (66)

Oyo (61)

Kwara (61)

Kaduna (59)

contraceptive meaning (+ 60%)

postinor 2 (+ 60%)

postinor (+ 50%)

contraceptive pills (100)

contraceptive pill (58)

what is contraceptive (35)

postinor (30)

postinor 2 (24)
Abortion

Imo (100)

Benue (95)

Taraba (95)

Abia (83)

Ebonyi (79)

1 day bleeding after abortion

abortion drugs for 3 weeks pregnancy

is abortion legal in Nigeria

does abortion pills damage the womb

how long does it take for misoprostol to dissolve

pregnancy (100)

abortion pills (74)

what is abortion (64)

abortion drugs (52)

abortion pill (51)
STI

Enugu (100)

Delta (98)

Abia (95)

Ogun state (70)

Oyo (59)

sti symptoms (100)

std (71)

what is sti (70)

symptoms of sti (63)

sti meaning (50)
ED

Enugu (100)

Akwa ibom (74)

Anambra (62)

Delta (53)

Osun (50)

 viagra (+ 50%)

what is erectile dysfunction (100)

causes of erectile dysfunction (97)

erectile dysfunction drugs (90)

erectile dysfunction treatment (75)

premature ejaculation (62)
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STI: Sexually transmitted infections, ED: erectile dysfunction, FCT: Federal Capital Territory.

The SVIs for “what is sti” increased from 67 (pre-COVID period) to 70 (COVID period), while “meaning of sti” increased from 33 (pre-COVID period) to 50 (COVID period). The SVIs for “What is erectile dysfunction” increased from 63 (pre-COVID period) to 100 (COVID period), while “erectile dysfunction treatment” increased from 60 (pre-COVID period) to 75 (COVID period).

On the contrary, the SVIs for “abortion drugs” dropped from 77 (pre-COVID period) to 52 (COVID period), while “abortion pills” dropped from 100 (pre-COVID period) to 74 (COVID period), and “abortion pill” dropped from 64 (pre-COVID period) to 51 (COVID period).

The mean SVIs for the selected sexual and reproductive health challenges during the pre-COVID and COVID periods are presented in Table 3; Fig. 1. The mean rank for COVID significantly increased in the COVID period compared to the pre-COVID period (P = 0.000). The mean rank for porn also increased significantly in the COVID period compared to the pre-COVID period (P = 0.000). The mean rank for rape (P = 0.000), contraceptive (P = 0.000), abortion (P = 0.000), STI (P = 0.000), and ED (P = 0.000) reduced significantly in the COVID period compared to the pre-COVID period.

Table 3.

Comparison of the mean search volume index during the pre-COVID and COVID periods.

COVID Groups N Mean Rank P values
Pre-COVID 103 56.36 5805.00 0.000
COVID 53 121.53 6441.00
Total 156
Sex Pre-COVID 103 74.51 7674.50 0.123
COVID 53 86.25 4571.50
Total 156
Porn Pre-COVID 103 65.45 6741.50 0.000
COVID 53 103.86 5504.50
Total 156
Rape Pre-COVID 103 105.00 10815.00 0.000
COVID 53 27.00 1431.00
Total 156
Contraceptive Pre-COVID 103 105.00 10815.00 0.000
COVID 53 27.00 1431.00
Total 156
Abortion Pre-COVID 103 105.00 10815.00 0.000
COVID 53 27.00 1431.00
Total 156
STI Pre-COVID 103 103.46 10656.00 0.000
COVID 53 30.00 5504.00
Total 156
ED Pre-COVID 103 104.72 10786.00 0.000
COVID 53 27.55 1460.00
Total 156
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Fig. 1.

Fig. 1

Fig. 1

Fig. 1

Open in a new tab

Mean search volume index of reproductive health-related issues during the Pre-COVID and COVID periods.

Correlational studies revealed that the SVIs for COVID were positively correlated with porn (P = 0.000), but negatively correlated with rape (P = 0.000), contraceptive (P = 0.000), abortion (P = 0.000), STI (P = 0.000), and ED (P = 0.000) (Table 4).

Table 4.

Correlation of COVID search volume index with those of reproductive health-related issues.

Variables Correlation coefficient P-value
Sex 0.106 0.190
Porn 0.385 0.000
Rape −0.610 0.000
Contraceptive −0.581 0.000
Abortion −0.630 0.000
STI −0.617 0.000
ED −0.652 0.000
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Discussion

COVID-19 and the lockdown measures instituted to curb the spread of the virus affected almost all aspects of life, including sexual and reproductive health. The present study showed that COVID-19 pandemic was associated with a change in internet search behaviour for sexual and reproductive health. This study also revealed that the SVIs for porn were significantly higher during the COVID-19 pandemic when compared with the pre-COVID period. More so, internet search behaviour for porn was positively correlated with COVID-19, while internet search behaviour for rape, contraceptive, abortion, STI, and ED was negatively correlated with COVID-19.

Our finding from the present study revealed that sexual behaviour, as predicted by the internet search behaviour using GT, was similar between the pre-COVID and COVID periods. This may infer that COVID-19 might not necessarily affect sexual behaviour. This finding is in agreement with the reports of Chen et al.38 and Zhang et al.39 that showed that COVID-19 did not significantly modify the frequency of sexual intercourse and quality of sexual life. However, it is not in agreement with the findings of some other studies40–43 that demonstrated a significant decline in the number of sexual intercourses and sexual satisfaction. The lockdown measure was a trigger of boredom, which is considered a possible inducer of hypersexual behaviour44. Unexpectedly, COVID-19 did not increase sexual behaviour despite the associated lockdown that was expected to improve bonding and sexual intimacy. The hypersexual behaviour was likely invested in solitary sexual behaviour such as viewing sexual content and masturbation since our findings revealed that porn search significantly increased during the COVID-19 period compared with the pre-COVID period. This corroborates the notion that boredom is a significant predictor and promoter of porn use45, and porn consumption is a key tool to relieve boredom46. The rise in porn consumption may also be due to men’s novelty-seeking behaviour to reduce monotony and increase arousal7 and cope with stress and loneliness8.

The present findings of reduced SVIs for ED but increased search for “what is erectile dysfunction” and “erectile dysfunction treatment” during the COVID-19 pandemic when compared with the pre-COVID period may indicate that although the total search for ED-related issues was reduced during the pandemic, there was a deeperd concern for the meaning of ED and the treatment of ED. This may reflect an increased ED accompanied by self-diagnosis and inquiry for ED management during the pandemic. The observed increase in porn consumption may explain the likely unaltered interest in real physical sexual intimacy and the rise in ED. This aligns with previous studies6,47 that reported a rise in incident ED during the COVID-19 pandemic.

In the current study, SVI for rape significantly reduced during the COVID-19 pandemic compared to the pre-COVID period but the query “how to rape” increased. This indicates that the intention to rape increased during the pandemic. This finding is in tandem with the reports of Smith et al.48 and Ogunlana et al.49 that showed an increased number of rape cases, including sexual violence from intimate partners50, during the COVID pandemic. Our finding of the increased rape incidence during the COVID-19 pandemic also mirrors the incidence of rape reported in Bangladesh14,51. The surge in rape cases during the pandemic may be associated with the lockdown that promoted victims to be trapped by sexual predators48.

The observed increase in rape intent and reported an increase in the number of rape cases during the COVID pandemic may explain the increased internet search for “postinor”, an emergency contraceptive. Although the SVIs for contraceptives and abortion were lower during the COVID-19 pandemic when compared with the pre-COVID period, the search for an emergency contraceptive, particularly postinor, was increased during the pandemic. The rape victims likely opted for the use of postinor to prevent pregnancy.

This study also observed that the mean SVI for STI was reduced during the COVID pandemic compared with the pre-COVID period but the search rates for “what is sti” and “meaning of sti” were increased. The reduced SVI for STI corroborates the findings of Sentís et al.22 who reported a decline in the incidence of STI, however, this may just be an artifact. The drop in incident STIs may be due to reduced hospital visits during the pandemic6. The increased search rate for the meaning of STI may suggest self-diagnosis. Since there were restrictions on movement during the pandemic, hospital visits significantly reduced6, and likely led to a drop in STI case reports but promoted self-diagnosis. The possible increase in incident STI, although not reported, may be an aftermath of increased rape cases.

Limitations

There are some limitations to this study. First, it is impossible to distinguish search interests by subgroups, such as medical personnel, students, and artisans, hence the SVIs and observed associations may not be a true reflection of the studied population. In addition, this study is an Infodemiology that may be limited by the level of education of the population amidst other confounding variables, thus a traditional survey may be required to validate our findings. Furthermore, this is a descriptive study and the findings do not provide causal factors. Clinical data may be needed to supplement these reports.

Additionally, several confounding factors may influence the findings of this study. First, extensive media coverage of COVID-19 possibly increased online searches related to the novel virus by raising awareness and concerns among the Nigerian population59. The increased public health campaigns designed to educate the public on COVID-19 during the pandemic could have contributed to increased searches for related queries to seek more information. The observed search internet search behaviour may also be a proxy for health-seeking behaviour. Also, in many cultures in Nigeria, discussing reproductive and sexual health issues is stigmatized and could influence online searches for related topics. Educational level, rural/urban residence, and economic status may also influence internet use and the search for topics related to reproductive and sexual health60. However, this study presents useful information because it provides data on a real-time basis and web searches are performed anonymously, allowing a wider range of data-sensitive topics. Also, specific search queries related to sexual and reproductive health were evaluated, and the study captured trends that may reflect real societal issues, although it could not distinguish between different subgroups like medical personnel, students, and artisans. Another major strength of the study is the size of the population studied and the inclusion of significant segments of the Nigerian population which enhances the generalizability of the findings. Infodemiology includes a greater percentage of the population in as much as there is internet access to the populace.

Based on the findings of the present study, the implications for policy and intervention include targeted health education. It is important to tailor public health campaigns that address the increased online search interest in harmful behavior, especially those related to reproductive and sexual health. Educational programs should focus on healthy relationships and safe sexual behavior. With an observed increase in searches for emergency contraceptive methods like “postinor” and queries related to STIs, it is pertinent that health authorities improve access to information and services regarding emergency contraception and STI prevention and treatment, especially in high-search areas. Since there was a rise in internet searches during the pandemic, this provides an opportunity to develop and promote credible online resources that would provide accurate information about reproductive and sexual health and counteract misinformation with an attempt to guide individuals in making informed decisions. More so, continuous monitoring and evaluation of internet search behaviour may serve as an early warning system for emerging public health issues and policymakers can promptly identify public health interest shifts and respond promptly with appropriate interventions and resources. Identifying the correlation between increased porn consumption and the search for erectile dysfunction, healthcare services should integrate mental health support with sexual health services, thus providing a comprehensive approach to care by counseling and supporting individuals experiencing anxiety or other mental health challenges related to sexual health. It is also crucial to collaborate with online platforms and search engines to promote sexual health education initiatives and disseminate vital health information, normalize discussions around sexual health, and combat stigma. These would improve the response to the altered landscape of sexual and reproductive health inquiry in light of the COVID-19 pandemic.

Conclusion

During the COVID-19 pandemic, online searches for specific terms like “how to rape,” “postinor,” and STI/ED-related queries increased in Nigeria. This suggests a rise in intent for risky behaviour, emergency contraception needs, and self-diagnosis of STIs and ED. These trends are linked to increased porn consumption. The long-term effects of the pandemic highlight the need for research on sexual health education and policy-making. Since the impacts of COVID-19 may last beyond the lockdown period, it is important to foster research to aid health education and policy-making, especially in matters related to sexual and reproductive health. A global survey on the impacts of the COVID-19 pandemic on sexual and reproductive health is also recommended to confirm whether or not the observations within Nigeria are similar to other countries. In addition, longitudinal studies to elucidate causal relationships between COVID-19 and sexual and reproductive health outcomes are suggested.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary Material 1 (18.3KB, zip)
Supplementary Material 2 (34.5KB, doc)

Author contributions

Conception and Design: Akhigbe RE, Akhigbe TMData collection: Akhigbe REValidation: Akhigbe RE and Akhigbe TMDrafting the Article: Akhigbe RE, Akhigbe TM, Hamed MA, and Adeyemi DH.Revision of for Intellectual Content: Akhigbe RE, Akhigbe TM, Hamed MA, and Adeyemi DH.Final Approval of the Completed Article: Akhigbe RE, Akhigbe TM, Hamed MA, and Adeyemi DH.

Data availability

Data will be made available upon reasonable request from the corresponding author.

Declarations

Competing interests

The authors declare no competing interests.

Footnotes

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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