Table 2. Identified human metabolites strongly associated with different categories of urogenitalschistosomiasis (fdr<0.05, delta>2, VIP score >1.5).

Metabolite/ Retention Time (min)	Putative Identity	Abundance in	Fold increase (compared to other groups)	Biochemical pathway	Ionisation; Sample
269.1900/9.4; 287.2002/9.4	Estrogen/Androgen precursors	Control	2.3–2.4	steroid biosynthesis &degradation	Positive;urine
383.2063/11.1	TLB	Control	2.5	lipid metabolism	Positive;urine
209.0662/1.4	Fucosylated sugar	Control	<2–2.8	Fructose and mannose metabolism	Negative;plasma
367.1588/10.2	modified estradiol/Testosterone	Advanced	<2–2.3	steroid hormone synthesis	Negative;plasma
180.0655/7.1	Adrenochrome O-quinone	Infection-only	2.1–3.3	Parasite-modified host metabolite	Positive;plasma
267.0741/9.2	Indolylacryloylglycine	Advanced/Infection-only	2.5	Tryptophan metabolism	Positive;urine
785.5880/16.7	N-Glycoloylganglioside GM2	Advanced	3.4–5.5	sphingolipid metabolism	Positive;plasma
807.5723/17.1	Phosphatidylcholine (PC)	Advanced	2.2–4.3	Choline metabolism in cancer/glycerophospholipid metabolism	Positive;plasma
806.5689/17.1	Phosphatidylethanolamine (PE	Advanced	<2–3.3	Choline metabolism in cancer/glycerophospholipid metabolism	Positive;plasma
512.2999/13.6	LysoPC(14:0)/1HGPE	Advanced	2.0–2.8	Choline metabolism in cancer/glycerophospholipid metabolism	Negative;plasma
180.0541/7.6	3-Succinoylpyridine	Infection only	2.9–4.0	Parasite-modified host metabolite	Negative;plasma

Metabolite identification was through accurate mass, spectral library match, retention time, adduct/isotope combinations and biological context. Advanced—urogenital schistosomiasis induced-pathology cases; Infection-only–urogenital schistosomiasis alone, Pathology-only—pathology with no detectable urogenital schistosomiasis; Control–no infection or pathology. HGPE—1-Heptadecanoylglycerophosphoethanolamine; TLB—12-Oxo-20-trihydroxy-leukotriene B4.